Individual
STACY KIRKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
220 BERGER RD, PADUCAH, KY 42003-4522
(270) 441-0030
Mailing address
220 BERGER RD, PADUCAH, KY 42003-4522
(270) 441-0030
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
297211
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
38328
IL
104100000X
Social Worker
150112934
IL
Other
Enumeration date
04/28/2021
Last updated
03/14/2025
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