Provider Demographics
NPI:1184218182
Name:THE PLAYROOM, LLP
Entity Type:Organization
Organization Name:THE PLAYROOM, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:859-428-8122
Mailing Address - Street 1:1050 CHINOE RD STE 207
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-6571
Mailing Address - Country:US
Mailing Address - Phone:859-428-8122
Mailing Address - Fax:
Practice Address - Street 1:1050 CHINOE RD STE 207
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-6571
Practice Address - Country:US
Practice Address - Phone:859-428-8122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100493900Medicaid