Provider Demographics
NPI:1215301304
Name:VANHORN, KARIN LOUCILE THOMPSON (LPCA)
Entity type:Individual
Prefix:MS
First Name:KARIN LOUCILE
Middle Name:THOMPSON
Last Name:VANHORN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 FRONTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-7730
Mailing Address - Country:US
Mailing Address - Phone:606-365-2197
Mailing Address - Fax:
Practice Address - Street 1:322 FRONTIER BLVD
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-7730
Practice Address - Country:US
Practice Address - Phone:606-365-2197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-30
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLPCCCA00223147101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1790731081Medicaid