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General NPI Number Information
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NPI Number | 1689295289
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Entity Type | Organization
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Legal Business Name | KENTUCKY INTENSIVE FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 1029 S FORT THOMAS AVE STE B
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City | FORT THOMAS
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State | KY
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Zip | 41075-2315
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Country | US
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Telephone | 859-647-0787
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Fax | 859-647-6594
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Provider Business Mailing Address
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Address Line | 1029 S FORT THOMAS AVE STE B
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City | FORT THOMAS
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State | KY
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Zip | 41075-2315
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Country | US
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Telephone | 859-250-2262
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JESSICA LEE SCHNEIDER
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Credential | LCSW
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Telephone | 859-647-0787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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