# COMMUNITY SUPPORT OUTREACH AGENCY LLC

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

## Provider details

- **NPI number:** 1134006109
- **Authorized official:** MS. LASHONDA ROBERTSON (OWNER)
- **Authorized official phone:** (502) 612-5495

## Contact information

- **Practice address:** 1827 W BROADWAY, LOUISVILLE, KY 40203-3547
- **Practice address phone:** (502) 963-5792
- **Practice address fax:** (502) 653-7063
- **Mailing address:** 11126 COMPASS AVE, LOUISVILLE, KY 40229-8391
- **Mailing address phone:** (502) 612-5495
- **Mailing address fax:** (502) 653-7063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 175T00000X | Peer Specialist | — | NULL | — |
| 175T00000X | Peer Specialist | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/20/2025
- **Last updated:** 08/20/2025