| Lena Embry Lcsw Llc | |
|
4602 Southern Pkwy Ste 1d Louisville KY 40214-1429 | |
| (812) 491-1307 | |
| (928) 202-4458 |
| Full Name | Lena Embry Lcsw Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4602 Southern Pkwy Ste 1d, Louisville, Kentucky |
| Authorized Official Name and Position | Lena Embry (OWNER) |
| Authorized Official Contact | 9282985100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lena Embry Lcsw Llc Po Box 3276 Evansville IN 47731-3276 Ph: (812) 473-0181 | Lena Embry Lcsw Llc 4602 Southern Pkwy Ste 1d Louisville KY 40214-1429 Ph: (812) 491-1307 |
| NPI Number | 1922738285 |
|---|---|
| Provider Enumeration Date | 06/10/2022 |
| Last Update Date | 05/16/2023 |
| Certification Date | 05/04/2023 |
| Medicare PECOS PAC ID | 6901261239 |
|---|---|
| Medicare Enrollment ID | O20230420001290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922738285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Lena Embry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073179370 PECOS PAC ID: 6800129313 Enrollment ID: I20190613003353 |
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