| Louisville Mental Health Group | |
|
4229 Bardstown Rd Ste 322 Louisville KY 40218-3241 | |
| (502) 417-2299 | |
| (502) 888-9771 |
| Full Name | Louisville Mental Health Group |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4229 Bardstown Rd Ste 322, Louisville, Kentucky |
| Authorized Official Name and Position | Kimberly Marie Sullivan (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5024172299 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisville Mental Health Group 4229 Bardstown Rd Ste 322 Louisville KY 40218-3241 Ph: (502) 417-2299 | Louisville Mental Health Group 4229 Bardstown Rd Ste 322 Louisville KY 40218-3241 Ph: (502) 417-2299 |
| NPI Number | 1386140358 |
|---|---|
| Provider Enumeration Date | 03/30/2018 |
| Last Update Date | 06/10/2022 |
| Certification Date | 06/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386140358 | NPI | - | NPPES |
| 7100307100 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3275 (Kentucky) | Primary |
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