Provider Demographics
NPI:1275649469
Name:ADVANCED SOLUTIONS OF CENTRAL KENTUCKY LLC
Entity Type:Organization
Organization Name:ADVANCED SOLUTIONS OF CENTRAL KENTUCKY LLC
Other - Org Name:ADVANCED SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:DALLAS
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-684-5669
Mailing Address - Street 1:1018 E NEW CIRCLE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-4138
Mailing Address - Country:US
Mailing Address - Phone:859-684-5669
Mailing Address - Fax:
Practice Address - Street 1:1018 E NEW CIRCLE RD STE 204
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-4138
Practice Address - Country:US
Practice Address - Phone:859-684-5669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1878101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty