Provider Demographics
NPI:1194922856
Name:SEMONES, SOPHIA YVONNE (MS)
Entity type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:YVONNE
Last Name:SEMONES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-2709
Mailing Address - Country:US
Mailing Address - Phone:502-875-1646
Mailing Address - Fax:502-875-1646
Practice Address - Street 1:959 LEESTOWN LN
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-2005
Practice Address - Country:US
Practice Address - Phone:502-875-8666
Practice Address - Fax:502-875-1646
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-117103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY217OtherPUSH
KY1619OtherFIRST STEPS