Provider Demographics
NPI:1366867020
Name:LAFEVER, CHRISTOPHER RYAN (MS LPCA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RYAN
Last Name:LAFEVER
Suffix:
Gender:M
Credentials:MS LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 CUBA RD
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-6809
Mailing Address - Country:US
Mailing Address - Phone:270-247-2588
Mailing Address - Fax:270-247-0142
Practice Address - Street 1:1525 CUBA RD
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-6809
Practice Address - Country:US
Practice Address - Phone:270-247-2588
Practice Address - Fax:270-247-0142
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR57297Medicare UPIN