Provider Demographics
NPI:1972121838
Name:HALL, DENNIS LOUIS (LCADC, LPCA, CCS,)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:LOUIS
Last Name:HALL
Suffix:
Gender:M
Credentials:LCADC, LPCA, CCS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 PEAKS MILL RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-8398
Mailing Address - Country:US
Mailing Address - Phone:502-229-4017
Mailing Address - Fax:502-699-2890
Practice Address - Street 1:140 KINGS DAUGHTERS DR STE 400
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4242
Practice Address - Country:US
Practice Address - Phone:502-699-2889
Practice Address - Fax:502-699-2890
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272976101YA0400X
KY286734101YM0800X
KY171M00000X
KY288593101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator