Provider Demographics
NPI:1477033546
Name:CORNETT, HEATHER LAUREN (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:LAUREN
Last Name:CORNETT
Suffix:
Gender:
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 DARBY CREEK RD STE 7
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1605
Mailing Address - Country:US
Mailing Address - Phone:859-285-6534
Mailing Address - Fax:502-324-3210
Practice Address - Street 1:501 DARBY CREEK RD STE 7
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1605
Practice Address - Country:US
Practice Address - Phone:859-687-5843
Practice Address - Fax:502-324-3210
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY282020103TC0700X, 103TC1900X, 103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical