Provider Demographics
NPI:1003174111
Name:KIRKLAND, HEATHER GODWIN (MS, LPCC-S, JSOCC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:GODWIN
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:MS, LPCC-S, JSOCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4185 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1736
Mailing Address - Country:US
Mailing Address - Phone:859-873-9277
Mailing Address - Fax:859-873-9280
Practice Address - Street 1:4185 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1736
Practice Address - Country:US
Practice Address - Phone:859-873-9277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174223101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional