Provider Demographics
NPI:1487174694
Name:UPDIKE, DARIANN NICOLE (MED, LPCC, PBSS)
Entity type:Individual
Prefix:MRS
First Name:DARIANN
Middle Name:NICOLE
Last Name:UPDIKE
Suffix:
Gender:F
Credentials:MED, LPCC, PBSS
Other - Prefix:MS
Other - First Name:DARIANN
Other - Middle Name:NICOLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCA, PBSS
Mailing Address - Street 1:250 ROB SMITH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-4214
Mailing Address - Country:US
Mailing Address - Phone:270-378-0122
Mailing Address - Fax:
Practice Address - Street 1:317 KOEHLER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-9388
Practice Address - Country:US
Practice Address - Phone:270-321-4198
Practice Address - Fax:270-795-4006
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173530101YM0800X
KY292326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health