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NPI Code Detail

MEDICARE: KIMBERLY KAY MCCLANAHAN PHD

MEDICARE: KIMBERLY KAY MCCLANAHAN PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist1403KY
2101YA0400XAddiction (Substance Use Disorder) Counselor0903KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134145568
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY KAY MCCLANAHAN PHD
Provider Business Mailing Address
First Line : PO BOX 790
Second Line :
City : ASHLAND
State : KY
Zip : 41105-0790
Country : US
Telephone Number : 606-329-8588
Fax Number : 606-329-8195
Provider Business Practice Location Address
First Line : 1212 BATH AVE
Second Line :
City : ASHLAND
State : KY
Zip : 41101-2696
Country : US
Telephone Number : 606-329-8588
Fax Number : 606-329-8195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 04/24/2014

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Directions to “ KIMBERLY KAY MCCLANAHAN PHD” Practice Location

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