Doctor Name: | KELLEY J GANNON |
NPI Number: | 1053460931 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 1728 |
Business Practice Address: | 191 Doctors Dr Frankfort, KY - 406014101 |
Business Phone Number: | 8592531686 |
Business Fax Number: | 8592542743 |
Mailing Address: | 1351 Newtown Pike, LEXINGTON |
State: | KY |
Postal Code: | 405111217 |
Phone Number: | 8592531686 |
Fax Number: | 8592532743 |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 1728 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |