Provider Demographics
NPI:1073053138
Name:WARREN, ARIANA (MS)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2816 BLUEGRASS DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:KY
Mailing Address - Zip Code:41076-1577
Mailing Address - Country:US
Mailing Address - Phone:859-442-8500
Mailing Address - Fax:859-442-8555
Practice Address - Street 1:2816 BLUEGRASS DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:KY
Practice Address - Zip Code:41076
Practice Address - Country:US
Practice Address - Phone:859-442-8500
Practice Address - Fax:859-442-8555
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY610661458OtherTAX ID