Provider Demographics
NPI:1740561141
Name:CASELDEN, KENNETH E (LPCC, LCADC)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:E
Last Name:CASELDEN
Suffix:
Gender:M
Credentials:LPCC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4733
Mailing Address - Country:US
Mailing Address - Phone:270-228-2991
Mailing Address - Fax:270-228-2994
Practice Address - Street 1:1000 E 18TH ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4733
Practice Address - Country:US
Practice Address - Phone:270-228-2991
Practice Address - Fax:270-228-2994
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY170819101YA0400X
KY103835101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
12289275OtherCAQH
KY7100441920Medicaid
KY7100279790Medicaid