Provider Demographics
NPI:1669952081
Name:WOOSLEY, KEVIN (MSW, CADC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:WOOSLEY
Suffix:
Gender:M
Credentials:MSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1094 US HIGHWAY 27 S STE A
Mailing Address - Street 2:
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-7078
Mailing Address - Country:US
Mailing Address - Phone:859-569-3145
Mailing Address - Fax:
Practice Address - Street 1:1094 US HIGHWAY 27 S STE A
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-7078
Practice Address - Country:US
Practice Address - Phone:859-569-3145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional