Provider Demographics
NPI:1801671227
Name:MALONE, KENNETHA MICHELLE (LPCC)
Entity type:Individual
Prefix:
First Name:KENNETHA
Middle Name:MICHELLE
Last Name:MALONE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 S HANCOCK ST APT B100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2449
Mailing Address - Country:US
Mailing Address - Phone:502-242-7458
Mailing Address - Fax:
Practice Address - Street 1:760 S HANCOCK ST
Practice Address - Street 2:B100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2449
Practice Address - Country:US
Practice Address - Phone:502-242-7458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health