| Heartwood Therapy Place Llc | |
|
1941 Bishop Ln Ste 1019 Louisville KY 40218-1928 | |
| (502) 851-6384 | |
| Not Available |
| Full Name | Heartwood Therapy Place Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1941 Bishop Ln Ste 1019, Louisville, Kentucky |
| Authorized Official Name and Position | Laura R Smith (OWNER) |
| Authorized Official Contact | 5028516384 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartwood Therapy Place Llc 1941 Bishop Ln Ste 1019 Louisville KY 40218-1928 Ph: (502) 851-6384 | Heartwood Therapy Place Llc 1941 Bishop Ln Ste 1019 Louisville KY 40218-1928 Ph: (502) 851-6384 |
| NPI Number | 1285272088 |
|---|---|
| Provider Enumeration Date | 12/12/2019 |
| Last Update Date | 10/03/2024 |
| Certification Date | 10/03/2024 |
| Medicare PECOS PAC ID | 1052725405 |
|---|---|
| Medicare Enrollment ID | O20210127000852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285272088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Laura R Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598712747 PECOS PAC ID: 6507847662 Enrollment ID: I20040526000195 |
| Provider Name | Melissa Novak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861609158 PECOS PAC ID: 9234380957 Enrollment ID: I20121106000380 |
| Provider Name | Tessa A Stephens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164839940 PECOS PAC ID: 9133466634 Enrollment ID: I20190122002254 |
| Provider Name | Jennifer M Warawa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063901775 PECOS PAC ID: 7618208117 Enrollment ID: I20191015001819 |
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