Provider Demographics
NPI:1740659978
Name:KASEY R COMPTON & ASSOCIATES, PLLC
Entity type:Organization
Organization Name:KASEY R COMPTON & ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE PRACTICE CLINICIAN/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:606-401-2966
Mailing Address - Street 1:250 BELMONT AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-2427
Mailing Address - Country:US
Mailing Address - Phone:606-401-2966
Mailing Address - Fax:606-244-4111
Practice Address - Street 1:250 BELMONT AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-2427
Practice Address - Country:US
Practice Address - Phone:606-401-2966
Practice Address - Fax:606-244-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY1666101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100284320Medicaid