Provider Demographics
NPI:1558078519
Name:HADLEY, VICKIE (LPCA)
Entity Type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:
Last Name:HADLEY
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 LAKEWAY DR
Mailing Address - Street 2:
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642-4645
Mailing Address - Country:US
Mailing Address - Phone:270-866-9516
Mailing Address - Fax:270-866-9584
Practice Address - Street 1:2329 LAKEWAY DR
Practice Address - Street 2:
Practice Address - City:RUSSELL SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42642-4645
Practice Address - Country:US
Practice Address - Phone:270-866-9516
Practice Address - Fax:270-866-9584
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY281649101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor