Provider Demographics
NPI:1518765866
Name:LAFAVERS, LINDA RENEE (LPCA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:RENEE
Last Name:LAFAVERS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:RENEE
Other - Last Name:MORROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:93 PENDLETON HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-3458
Mailing Address - Country:US
Mailing Address - Phone:606-492-3057
Mailing Address - Fax:
Practice Address - Street 1:349 BOGLE ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2895
Practice Address - Country:US
Practice Address - Phone:606-485-4611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY286254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health