Individual
COURTNEY RUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CSW
Contact information
Practice address
1351 NEWTOWN PIKE BLDG 3, LEXINGTON, KY 40511-1278
(859) 455-7452
Mailing address
4713 SPRING CREEK DR, LEXINGTON, KY 40515-1524
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
255733
KY
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
01
—
255733
CSW LICENSE NUMBER
KY
Enumeration date
06/10/2021
Last updated
06/01/2022
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