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Individual

MRS. AUDREA BERRONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
218 MANDALAY RD, LEXINGTON, KY 40504
(859) 288-2425
(859) 721-3918
Mailing address
496 SOUTHLAND DR, LEXINGTON, KY 40503-1827
(859) 288-2392
(859) 721-3918

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3905
KY
1041C0700X
Clinical Social Worker
6249
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
270795565
KY
Enumeration date
01/11/2012
Last updated
05/23/2019
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