Provider Demographics
NPI:1609071331
Name:NUNLEY, KELLY S (MA, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:S
Last Name:NUNLEY
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 DARBY CREEK SUITE # 11
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509
Mailing Address - Country:US
Mailing Address - Phone:859-338-0466
Mailing Address - Fax:859-294-0802
Practice Address - Street 1:5011 ATWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475
Practice Address - Country:US
Practice Address - Phone:859-314-1281
Practice Address - Fax:859-353-8032
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0529101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100284980Medicaid