| Jayan Thomas Lcsw Llc | |
|
13113 Eastpoint Park Blvd Ste G Louisville KY 40223-4191 | |
| (502) 805-5858 | |
| (502) 805-5859 |
| Full Name | Jayan Thomas Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 13113 Eastpoint Park Blvd Ste G, Louisville, Kentucky |
| Authorized Official Name and Position | Jayan Thomas (PRESIDENT) |
| Authorized Official Contact | 5028055858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jayan Thomas Lcsw Llc 4103 Brownsboro Glen Rd Louisville KY 40241-1196 Ph: (502) 805-5858 | Jayan Thomas Lcsw Llc 13113 Eastpoint Park Blvd Ste G Louisville KY 40223-4191 Ph: (502) 805-5858 |
| NPI Number | 1386280683 |
|---|---|
| Provider Enumeration Date | 11/21/2019 |
| Last Update Date | 11/21/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386280683 | NPI | - | NPPES |
| 7100187730 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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