MEDICARE: KENTUCKY SERVICES, LLC

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	106H00000X	Marriage & Family Therapist

Other Identifiers

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

General Provider Information

NPI Number	:	1609448059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENTUCKY SERVICES, LLC

Provider Business Mailing Address
First Line	:	3150 CUSTER DR STE 203
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4010
Country	:	US
Telephone Number	:	502-219-3488
Fax Number	:	502-406-5803

Provider Business Practice Location Address
First Line	:	3150 CUSTER DR STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4010
Country	:	US
Telephone Number	:	502-219-3488
Fax Number	:	502-406-3488

Authorized Official
Title or Position	:	OWNER
Name	:	MARY JARNAGIN
Credential	:	LMFT
Telephone Number	:	859-227-9266

Provider Enumeration Date	:	07/14/2021
Last Update Date	:	06/11/2026

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Directions to “KENTUCKY SERVICES, LLC ” Practice Location

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