Provider Demographics
NPI:1255124848
Name:KITECK, ANDREW LOYAL (LPCA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:LOYAL
Last Name:KITECK
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 W HIGHWAY 80 STE 1
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2897
Mailing Address - Country:US
Mailing Address - Phone:606-802-2880
Mailing Address - Fax:606-802-2888
Practice Address - Street 1:647 W HIGHWAY 80 STE 1
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2897
Practice Address - Country:US
Practice Address - Phone:606-802-2880
Practice Address - Fax:606-802-2888
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY299351101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional