MEDICARE: MRS. JALIAH CLARISSA DAY-KLAIBER MSW,LCSW

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
1	1041C0700X	Clinical Social Worker	3401	KY

General Provider Information

NPI Number	:	1578714754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JALIAH CLARISSA DAY-KLAIBER MSW,LCSW

Provider Business Mailing Address
First Line	:	768 ROSSLYNS DL
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40514-1188
Country	:	US
Telephone Number	:	859-245-1337
Fax Number	:	859-245-1338

Provider Business Practice Location Address
First Line	:	216 EAST REYNOLDS ROAD
Second Line	:	SUITE F
City	:	LEXINGTON
State	:	KY
Zip	:	40517-1188
Country	:	US
Telephone Number	:	859-245-1337
Fax Number	:	859-245-1338

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2008
Last Update Date	:	06/11/2012

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