| Louisville Ocd Clinic | |
|
11824 Ransum Dr Ste 100 Louisville KY 40243-2802 | |
| (502) 338-0608 | |
| (502) 245-1888 |
| Full Name | Louisville Ocd Clinic |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 11824 Ransum Dr Ste 100, Louisville, Kentucky |
| Authorized Official Name and Position | Justin Brent Wallen (BUSINESS MANAGER) |
| Authorized Official Contact | 5023193105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisville Ocd Clinic 2107 Strathmoor Blvd Louisville KY 40205-2529 Ph: (502) 319-3105 | Louisville Ocd Clinic 11824 Ransum Dr Ste 100 Louisville KY 40243-2802 Ph: (502) 338-0608 |
| NPI Number | 1568971950 |
|---|---|
| Provider Enumeration Date | 09/28/2017 |
| Last Update Date | 05/25/2021 |
| Certification Date | 05/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568971950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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