Provider Demographics
NPI:1558071142
Name:MITCHELL, KARLY (LPCC)
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 BELLEFONTE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3210
Mailing Address - Country:US
Mailing Address - Phone:859-559-3826
Mailing Address - Fax:
Practice Address - Street 1:230 LEXINGTON GREEN CIR STE 420
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3337
Practice Address - Country:US
Practice Address - Phone:859-559-3826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY280415101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health