| NPI | 1265858864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACIE A SYLVESTER Member 502-350-7368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 251S00000X | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2024-01-24 |