Provider Demographics
NPI:1154512531
Name:KIRKPATRICK, KRISTIN LECLAIR (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:LECLAIR
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 LANCASTER AVE
Mailing Address - Street 2:SSB 571, CPO 52
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3100
Mailing Address - Country:US
Mailing Address - Phone:859-622-1303
Mailing Address - Fax:859-622-1305
Practice Address - Street 1:521 LANCASTER AVE
Practice Address - Street 2:SSB 571, CPO 52
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3100
Practice Address - Country:US
Practice Address - Phone:859-622-1303
Practice Address - Fax:859-622-1305
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1442103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYKY-1442OtherKY BD OF EXAMINERS OF PSY