Provider Demographics
NPI:1104557560
Name:STRONG, CELESTA RAINNIA LYNNETTE
Entity type:Individual
Prefix:
First Name:CELESTA
Middle Name:RAINNIA LYNNETTE
Last Name:STRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 KAY ST # 2227
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-4642
Mailing Address - Country:US
Mailing Address - Phone:606-485-4003
Mailing Address - Fax:
Practice Address - Street 1:66 GARRARD SQ
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-5759
Practice Address - Country:US
Practice Address - Phone:606-681-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator