Provider Demographics
NPI:1053112268
Name:AYA MENTAL HEALTH
Entity type:Organization
Organization Name:AYA MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ELISABETH
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:740-776-8941
Mailing Address - Street 1:2520 MAYSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41041-8121
Mailing Address - Country:US
Mailing Address - Phone:740-776-8941
Mailing Address - Fax:
Practice Address - Street 1:730 KENTON STATION RD
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-9619
Practice Address - Country:US
Practice Address - Phone:606-554-3048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)