Basic Information
| Provider Information | |||||||||
| NPI: | 1326706235 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOLL | ||||||||
| FirstName: | MCKAYLA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | LPCC, LCADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10401 LINN STATION RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402233842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025898600 | ||||||||
| FaxNumber: | 5025898745 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 S PRESTON ST | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402021716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025893951 | ||||||||
| FaxNumber: | 5025819234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2021 | ||||||||
| LastUpdateDate: | 07/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 270616 | KY | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | 274544 | KY | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.