Provider Demographics
NPI:1295098309
Name:ADKINS, SHELLEY KAYE
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:KAYE
Last Name:ADKINS
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 1:2255 KNOX AVE
Mailing Address - Street 2:
Mailing Address - City:VINE GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:40175-9401
Mailing Address - Country:US
Mailing Address - Phone:270-877-2024
Mailing Address - Fax:
Practice Address - Street 1:2255 KNOX AVE
Practice Address - Street 2:
Practice Address - City:VINE GROVE
Practice Address - State:KY
Practice Address - Zip Code:40175-9401
Practice Address - Country:US
Practice Address - Phone:270-877-2024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical