Doctor Name: | MR. KEITH LAKES |
NPI Number: | 1316303654 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPCC |
License Number: | 0224 |
Business Practice Address: | 11623 Highway 3630 Annville, KY - 40402 |
Business Phone Number: | 6063643640 |
Business Fax Number: | 6063642534 |
Mailing Address: | 11623 Highway 3630, ANNVILLE |
State: | KY |
Postal Code: | 404028182 |
Phone Number: | 6063643640 |
Fax Number: | 6063642534 |
NPI Enumeration Date: | 12/31/2015 |
NPI Last Update Date: | 12/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 0224 |
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 |