Provider Demographics
NPI:1194242743
Name:GARRINGER-MACCABE, KELLY ELIZABETH (LPCC)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:ELIZABETH
Last Name:GARRINGER-MACCABE
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 1:448 LEWIS HARGETT CIR STE 260
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3506
Mailing Address - Country:US
Mailing Address - Phone:859-338-0466
Mailing Address - Fax:859-294-0802
Practice Address - Street 1:448 LEWIS HARGETT CIR STE 260
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3506
Practice Address - Country:US
Practice Address - Phone:859-338-0466
Practice Address - Fax:859-294-0802
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY172152101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100733410Medicaid