Provider Demographics
NPI:1669863585
Name:PEAY, WHITNEY DAWN (LPCC, NCC)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:DAWN
Last Name:PEAY
Suffix:
Gender:F
Credentials:LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 HUMPHREY RD
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42330-5603
Mailing Address - Country:US
Mailing Address - Phone:270-543-3531
Mailing Address - Fax:
Practice Address - Street 1:230 TECHNOLOGY WAY
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-8070
Practice Address - Country:US
Practice Address - Phone:270-543-3531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY168664101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100411930Medicaid
KY168664OtherLPCC