# AVA HEALTH AND WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083491138
- **Authorized official:** KATHLEEN BERGHAUSEN (OWNER)
- **Authorized official phone:** (502) 558-0916

## Contact information

- **Practice address:** 417 BENJAMIN LN STE 101, LOUISVILLE, KY 40222-4939
- **Practice address phone:** (502) 289-9306
- **Mailing address:** 6376 CLORE LN, CRESTWOOD, KY 40014-8042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2023
- **Last updated:** 09/20/2023