| Severo Therapy Llc | |
|
3400 Stony Spring Cir Louisville KY 40220-5428 | |
| (502) 627-0093 | |
| (502) 499-4431 |
| Full Name | Severo Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3400 Stony Spring Cir, Louisville, Kentucky |
| Authorized Official Name and Position | Christina Severo (OWNER/LCSW) |
| Authorized Official Contact | 5026270093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Severo Therapy Llc 3400 Stony Spring Cir Louisville KY 40220-5428 Ph: (502) 627-0093 | Severo Therapy Llc 3400 Stony Spring Cir Louisville KY 40220-5428 Ph: (502) 627-0093 |
| NPI Number | 1508563040 |
|---|---|
| Provider Enumeration Date | 02/15/2023 |
| Last Update Date | 02/15/2023 |
| Certification Date | 02/15/2023 |
| Medicare PECOS PAC ID | 7719350057 |
|---|---|
| Medicare Enrollment ID | O20230307001216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508563040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Christina A Severo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932830551 PECOS PAC ID: 7517349004 Enrollment ID: I20220730000266 |
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