Provider Demographics
NPI:1851721633
Name:KVC BEHAVIRORAL HEALTH
Entity Type:Organization
Organization Name:KVC BEHAVIRORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FPP SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:NIKI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:859-559-3637
Mailing Address - Street 1:900 BEASLEY ST
Mailing Address - Street 2:STE 120
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-4266
Mailing Address - Country:US
Mailing Address - Phone:859-254-1035
Mailing Address - Fax:
Practice Address - Street 1:900 BEASLEY ST
Practice Address - Street 2:STE 120
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-4266
Practice Address - Country:US
Practice Address - Phone:859-254-1035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty