Provider Demographics
NPI:1447635818
Name:TICHENOR, KATHY (LCSW)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:TICHENOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:769 LEGION DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-3109
Mailing Address - Country:US
Mailing Address - Phone:279-339-5670
Mailing Address - Fax:270-245-2113
Practice Address - Street 1:2100 N MAIN ST STE I
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-9007
Practice Address - Country:US
Practice Address - Phone:270-339-5670
Practice Address - Fax:270-245-2113
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2527431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical