Provider Demographics
NPI:1124910740
Name:SEMMES, KEVIN DAVID JR (LMHC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:DAVID
Last Name:SEMMES
Suffix:JR
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 PADEN DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:IN
Mailing Address - Zip Code:47941-8029
Mailing Address - Country:US
Mailing Address - Phone:765-239-9711
Mailing Address - Fax:
Practice Address - Street 1:616 PADEN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:IN
Practice Address - Zip Code:47941-8029
Practice Address - Country:US
Practice Address - Phone:765-239-9711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39005582A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty