Provider Demographics
NPI:1013517424
Name:ARDREY, WILLIAM (CSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:ARDREY
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:KUTTAWA
Mailing Address - State:KY
Mailing Address - Zip Code:42055-0250
Mailing Address - Country:US
Mailing Address - Phone:270-601-4235
Mailing Address - Fax:270-963-3038
Practice Address - Street 1:68 CEDAR ST
Practice Address - Street 2:
Practice Address - City:KUTTAWA
Practice Address - State:KY
Practice Address - Zip Code:42055-6287
Practice Address - Country:US
Practice Address - Phone:270-601-4235
Practice Address - Fax:270-963-3038
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY255247104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker