Provider Demographics
NPI:1609800283
Name:HOBSON, KERRY EDWARD (LMFT)
Entity Type:Individual
Prefix:MR
First Name:KERRY
Middle Name:EDWARD
Last Name:HOBSON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-1411
Mailing Address - Country:US
Mailing Address - Phone:606-564-4016
Mailing Address - Fax:606-564-8288
Practice Address - Street 1:611 FOREST AVE
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-1411
Practice Address - Country:US
Practice Address - Phone:606-564-4016
Practice Address - Fax:606-564-8288
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0527106H00000X
IN35001492A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30608012Medicaid