Provider Demographics
NPI:1346631512
Name:COUNSELING ASSOCIATION OF LEXINGTON
Entity Type:Organization
Organization Name:COUNSELING ASSOCIATION OF LEXINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-494-2388
Mailing Address - Street 1:274 SOUTHLAND DR
Mailing Address - Street 2:#204
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1946
Mailing Address - Country:US
Mailing Address - Phone:859-278-3456
Mailing Address - Fax:502-867-8164
Practice Address - Street 1:203 CHAMPION WAY STE 7
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8861
Practice Address - Country:US
Practice Address - Phone:502-867-1336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1297101YA0400X
KY61571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty