| NPI | 1487263729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH GOODMAN Lcsw 502-544-2192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2023-05-30 |