Provider Demographics
NPI:1780712810
Name:POSTON, JEFFREY (PSY)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:POSTON
Suffix:
Gender:M
Credentials:PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-0790
Mailing Address - Country:US
Mailing Address - Phone:606-329-8588
Mailing Address - Fax:606-329-8195
Practice Address - Street 1:WALKER HOUSE
Practice Address - Street 2:411 BISHOP COURT
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1009
Practice Address - Country:US
Practice Address - Phone:606-784-2096
Practice Address - Fax:606-784-5886
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30610026Medicaid
000000345166OtherANTHEM BCBS
11717035OtherCAQH