Provider Demographics
NPI:1487430286
Name:RENTEL, KATELYN ALEXANDRA (LPCC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ALEXANDRA
Last Name:RENTEL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 E KEYSER HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1639
Mailing Address - Country:US
Mailing Address - Phone:865-566-6512
Mailing Address - Fax:
Practice Address - Street 1:123 E KEYSER HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1639
Practice Address - Country:US
Practice Address - Phone:865-566-6512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY278245101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health