Individual
KIMBERLY KHADOO-BAYNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S
Contact information
Practice address
201 MECHANIC ST, LEXINGTON, KY 40507-1086
(859) 271-9448
(270) 858-4029
Mailing address
100 AZALEA PARK TRL APT 8, RADCLIFF, KY 40160-3900
(270) 272-2046
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
243316
KY
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
243316
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
05
—
7100592990
—
KY
Enumeration date
11/04/2013
Last updated
04/30/2024
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