Individual
CRAIG B CONGLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3175 CUSTER DR STE 200, LEXINGTON, KY 40517-4023
(859) 273-1288
(859) 273-1278
Mailing address
3175 CUSTER DR STE 200, LEXINGTON, KY 40517-4023
(859) 273-1288
(859) 273-1278
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
KY-725
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042911
KY ANTHEM BC/BS NUMBER
KY
Enumeration date
07/05/2006
Last updated
01/27/2008
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