Provider Demographics
NPI:1740260603
Name:KEMPTON, KATHY J (LPC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:J
Last Name:KEMPTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 WILLOW DRIVE
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-7535
Mailing Address - Country:US
Mailing Address - Phone:660-221-1238
Mailing Address - Fax:660-826-8847
Practice Address - Street 1:1650 WILLOW DR
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-8950
Practice Address - Country:US
Practice Address - Phone:660-221-1238
Practice Address - Fax:660-826-8847
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO23049-01-9OtherBLUE CROSS BLUE SHIELD
MO496940008Medicaid
MO001658OtherLPC