Provider Demographics
NPI:1275961849
Name:KVC BEHAVIORIAL HEALTHCARE
Entity Type:Organization
Organization Name:KVC BEHAVIORIAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONJI
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, CADC
Authorized Official - Phone:606-216-4186
Mailing Address - Street 1:5836 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:KY
Mailing Address - Zip Code:41855-9059
Mailing Address - Country:US
Mailing Address - Phone:606-216-4186
Mailing Address - Fax:
Practice Address - Street 1:561 N LAKE DR
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1278
Practice Address - Country:US
Practice Address - Phone:606-216-4186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health