Provider Demographics
NPI:1285973164
Name:PLYMALE, KATHRYN BLAIR (PHD, LPCC-S, RPT)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:BLAIR
Last Name:PLYMALE
Suffix:
Gender:F
Credentials:PHD, LPCC-S, RPT
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:HAYDEN
Other - Last Name:BLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:4414 OLD LAGRANGE RD
Mailing Address - Street 2:
Mailing Address - City:BUCKNER
Mailing Address - State:KY
Mailing Address - Zip Code:40010-9547
Mailing Address - Country:US
Mailing Address - Phone:502-222-2389
Mailing Address - Fax:502-222-2927
Practice Address - Street 1:256 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2078
Practice Address - Country:US
Practice Address - Phone:502-222-2389
Practice Address - Fax:502-222-2927
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY104990101YM0800X, 101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100903970Medicaid