Provider Demographics
NPI:1306093976
Name:BLANKENSHIP, KELI (LICENSED PSYCHOLOGIS)
Entity type:Individual
Prefix:DR
First Name:KELI
Middle Name:
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:LICENSED PSYCHOLOGIS
Other - Prefix:MRS
Other - First Name:KELI
Other - Middle Name:
Other - Last Name:BLANKENSHIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICENSED PSYCH ASSOC
Mailing Address - Street 1:448 LEWIS HARGETT CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3900
Mailing Address - Country:US
Mailing Address - Phone:859-582-4701
Mailing Address - Fax:
Practice Address - Street 1:448 LEWIS HARGETT CIR STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3900
Practice Address - Country:US
Practice Address - Phone:859-582-4701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0856103TC0700X
KY1617103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical