MEDICARE: MS. KATHLEEN L DOYLE 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	651	KY

General Provider Information

NPI Number	:	1891065819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN L DOYLE MSW, LCSW

Provider Business Mailing Address
First Line	:	1660 LINSTEAD DR.
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504
Country	:	US
Telephone Number	:	859-806-2029
Fax Number	:	859-278-0786

Provider Business Practice Location Address
First Line	:	620 EUCLID AVE.
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-6429
Country	:	US
Telephone Number	:	859-806-2029
Fax Number	:	859-278-0786

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

Provider Enumeration Date	:	01/06/2012
Last Update Date	:	01/13/2012

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