Provider Demographics
NPI:1730386772
Name:STARKEY, KENNETH RANDALL (PSYD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:RANDALL
Last Name:STARKEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1975
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-1975
Mailing Address - Country:US
Mailing Address - Phone:606-877-3479
Mailing Address - Fax:606-877-3479
Practice Address - Street 1:1308 WEST FIFTH STREET
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741
Practice Address - Country:US
Practice Address - Phone:606-877-3479
Practice Address - Fax:606-877-3479
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1062103G00000X, 103T00000X, 103TC0700X
KY0385103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)