Provider Demographics
NPI:1558107326
Name:MEADE, KATIE LYNN (CADC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:MEADE
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-7932
Mailing Address - Country:US
Mailing Address - Phone:606-263-4714
Mailing Address - Fax:606-263-4712
Practice Address - Street 1:290 E COURT ST
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-7932
Practice Address - Country:US
Practice Address - Phone:606-263-4714
Practice Address - Fax:606-263-4712
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY289815101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)