Provider Demographics
NPI:1518286673
Name:RELEFORD, KIMBERLY GRISWOLD (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:GRISWOLD
Last Name:RELEFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:GRISWOLD
Other - Last Name:DOTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BRACE
Mailing Address - Street 1:112 GARRARD ST
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-9242
Mailing Address - Country:US
Mailing Address - Phone:859-948-3000
Mailing Address - Fax:
Practice Address - Street 1:112 GARRARD ST
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-9242
Practice Address - Country:US
Practice Address - Phone:859-948-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3393104100000X
KY50921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker