Provider Demographics
NPI:1598223018
Name:KLUEH, KRISTY ELIZABETH (CSW, TCADC)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:ELIZABETH
Last Name:KLUEH
Suffix:
Gender:F
Credentials:CSW, TCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1372 DEER LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-5388
Mailing Address - Country:US
Mailing Address - Phone:859-519-8717
Mailing Address - Fax:
Practice Address - Street 1:389 WALLER AVE STE 200
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2900
Practice Address - Country:US
Practice Address - Phone:859-309-2384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY253744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health