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General NPI Number Information
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NPI Number | 1841125150
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Entity Type | Individual
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Provider Name | KRYSTAL LEE WOODS TCADC
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Gender | Female
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Dates
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Enumeration Date | 06/17/2026
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 213 MIDLAND BLVD
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City | SHELBYVILLE
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State | KY
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Zip | 40065-7791
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Country | US
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Telephone | 502-633-4043
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Fax |
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Provider Business Mailing Address
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Address Line | 6577 WOODS PIKE
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City | PLEASUREVILLE
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State | KY
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Zip | 40057-8650
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Country | US
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Telephone | 502-667-3669
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 300938
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License Number State | KY
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