| Therapeutic Intervention Services | |
|
9900 Corporate Campus Dr Louisville KY 40223-4050 | |
| (502) 762-6258 | |
| Not Available |
| Full Name | Therapeutic Intervention Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 9900 Corporate Campus Dr, Louisville, Kentucky |
| Authorized Official Name and Position | Lili S. Lutgens (MEMBER) |
| Authorized Official Contact | 5027626258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Intervention Services 4303 Emerald Way New Albany IN 47150-9330 Ph: () - | Therapeutic Intervention Services 9900 Corporate Campus Dr Louisville KY 40223-4050 Ph: (502) 762-6258 |
| NPI Number | 1932467867 |
|---|---|
| Provider Enumeration Date | 04/28/2012 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Medicare PECOS PAC ID | 8921324146 |
|---|---|
| Medicare Enrollment ID | O20150306000782 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932467867 | NPI | - | NPPES |
| 7100225100 | Medicaid | KY |
| Provider Name | Shannon M Gambill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770913436 PECOS PAC ID: 3173574258 Enrollment ID: I20050207000177 |
| Provider Name | Lili S Lutgens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205906765 PECOS PAC ID: 6901122126 Enrollment ID: I20150311002259 |
| Provider Name | Robyn Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659652477 PECOS PAC ID: 7214325315 Enrollment ID: I20211021003100 |
| Provider Name | Allison Nicole Burdenmeyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881340644 PECOS PAC ID: 9032504428 Enrollment ID: I20220322001296 |
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