Individual
LAURA WEITKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
451 BIG HILL AVE STE 5, RICHMOND, KY 40475-2596
(859) 428-7862
(859) 999-7869
Mailing address
PO BOX 802, BEREA, KY 40403-0802
(859) 428-7862
(859) 999-7869
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
275584
KY
101YP2500X
Professional Counselor
275584
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100796790
—
KY
Enumeration date
11/02/2018
Last updated
04/08/2024
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