Provider Demographics
NPI:1255806972
Name:PREVAIL COUNSELING & ASSOCIATES LLC
Entity type:Organization
Organization Name:PREVAIL COUNSELING & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORRIS-LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:859-439-0430
Mailing Address - Street 1:366 BOB O LINK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1104
Mailing Address - Country:US
Mailing Address - Phone:270-339-1344
Mailing Address - Fax:
Practice Address - Street 1:155 PROSPEROUS PL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1862
Practice Address - Country:US
Practice Address - Phone:859-439-0430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100580260Medicaid