Provider Demographics
NPI:1760760284
Name:MALINDA ISAACS, PHD PLC
Entity Type:Organization
Organization Name:MALINDA ISAACS, PHD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MALINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAACS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:859-428-8008
Mailing Address - Street 1:1031 WELLINGTON WAY STE 215
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1251
Mailing Address - Country:US
Mailing Address - Phone:859-428-8008
Mailing Address - Fax:859-286-6444
Practice Address - Street 1:1031 WELLINGTON WAY STE 215
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1251
Practice Address - Country:US
Practice Address - Phone:859-428-8008
Practice Address - Fax:859-286-6444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1569103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty