Pangburn, Kevin J

Pangburn, Kevin J is an individual health care provider with primary practice located at 4200 Buck Creek Rd , Floyds Knobs IN 47119-9216. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Pangburn, Kevin J can be contacted via phone (502) 861-6661.

Contact Information

Primary practice address
4200 Buck Creek Rd Floyds Knobs IN 47119-9216
Phone: (502) 861-6661
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1356920532
LBN Legal business name Pangburn, Kevin J
Credentials LCADC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2021
Last updated Apr 7th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356920532 NPPES
Kentucky MEDICAID 7100730680

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