Provider Demographics
NPI:1356739205
Name:STILLWELL, FRANK JAMES (DMIN, KLPC)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JAMES
Last Name:STILLWELL
Suffix:
Gender:M
Credentials:DMIN, KLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 VON SNEIDERN CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-1960
Mailing Address - Country:US
Mailing Address - Phone:859-940-3241
Mailing Address - Fax:
Practice Address - Street 1:240 RODES AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2615
Practice Address - Country:US
Practice Address - Phone:859-258-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKLPPCO00210691101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral