| Louisville Behavioral Health Systems Pllc | |
|
3430 Newburg Rd Suite 210 Louisville KY 40218-2497 | |
| (502) 454-8800 | |
| (502) 736-0140 |
| Full Name | Louisville Behavioral Health Systems Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3430 Newburg Rd, Louisville, Kentucky |
| Authorized Official Name and Position | Evelyn Rose Zwanzig (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5024548800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisville Behavioral Health Systems Pllc 3430 Newburg Rd Suite 210 Louisville KY 40218-2497 Ph: (502) 454-8800 | Louisville Behavioral Health Systems Pllc 3430 Newburg Rd Suite 210 Louisville KY 40218-2497 Ph: (502) 454-8800 |
| NPI Number | 1619088549 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 07/22/2021 |
| Certification Date | 07/22/2021 |
| Medicare PECOS PAC ID | 1759378946 |
|---|---|
| Medicare Enrollment ID | O20040429000117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619088549 | NPI | - | NPPES |
| 7100152610 | Medicaid | KY | |
| 7100041560 | Medicaid | KY |
| Provider Name | Mohamed S. Khodeir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801843024 PECOS PAC ID: 6002803483 Enrollment ID: I20040428000166 |
| Provider Name | Zafrin B Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174618540 PECOS PAC ID: 1153312855 Enrollment ID: I20040520001636 |
| Provider Name | Denise L Epperson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851440267 PECOS PAC ID: 6608864400 Enrollment ID: I20040526000474 |
| Provider Name | Michael Ray Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366493827 PECOS PAC ID: 5890773105 Enrollment ID: I20040713000329 |
| Provider Name | Kenneth Tildon Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275629685 PECOS PAC ID: 7315981206 Enrollment ID: I20050613000131 |
| Provider Name | Kevin Glenn Bays |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386695831 PECOS PAC ID: 0042249989 Enrollment ID: I20050810000923 |
| Provider Name | Jason N Stamper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780635250 PECOS PAC ID: 1759312366 Enrollment ID: I20050823001137 |
| Provider Name | Mary R Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114038056 PECOS PAC ID: 8820093073 Enrollment ID: I20060922000226 |
| Provider Name | Frank H Deland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851451793 PECOS PAC ID: 7810060415 Enrollment ID: I20080715000502 |
| Provider Name | Barry A Royalty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306944749 PECOS PAC ID: 3678623931 Enrollment ID: I20090608000179 |
| Provider Name | Azra Alomerovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336477140 PECOS PAC ID: 8325179757 Enrollment ID: I20100629000836 |
| Provider Name | Charles B Bensenhaver |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215031646 PECOS PAC ID: 6204906043 Enrollment ID: I20100721000099 |
| Provider Name | Walter R Butler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871603886 PECOS PAC ID: 9335201037 Enrollment ID: I20100824000669 |
| Provider Name | Cheryl I Denzik |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1821294042 PECOS PAC ID: 1153418959 Enrollment ID: I20131106000871 |
| Provider Name | Traci M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689127888 PECOS PAC ID: 6608162839 Enrollment ID: I20160914000648 |
| Provider Name | Clinton Rayhill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700330008 PECOS PAC ID: 8123300837 Enrollment ID: I20170112001944 |
| Provider Name | Linda Grill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851877443 PECOS PAC ID: 7416206222 Enrollment ID: I20180827002970 |
| Provider Name | Robert J Veliky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588871727 PECOS PAC ID: 0749612992 Enrollment ID: I20191109000122 |
| Provider Name | Jordan Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477146157 PECOS PAC ID: 2062828189 Enrollment ID: I20210315001437 |
| Provider Name | Kimberly Rae Vilt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083206742 PECOS PAC ID: 7911314950 Enrollment ID: I20210318001682 |
| Provider Name | Jensen Brooke Potenza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194259473 PECOS PAC ID: 4981006038 Enrollment ID: I20210712002389 |
| Provider Name | Dena Renae Koch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679251839 PECOS PAC ID: 9335596527 Enrollment ID: I20231109001409 |
| Provider Name | Karen Crane Quick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013307040 PECOS PAC ID: 1557702263 Enrollment ID: I20240513002259 |
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