# JENNIFER SHANKS, LCSW, LCADC

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

## Provider details

- **NPI number:** 1619775640
- **Authorized official:** JENNIFER SHANKS LCSW, LCADC (OWNER)
- **Authorized official phone:** (502) 548-5647

## Contact information

- **Practice address:** 161 SAINT MATTHEWS AVE STE 18, LOUISVILLE, KY 40207-3145
- **Practice address phone:** (502) 548-5647
- **Mailing address:** 907 BROADFIELDS DR, LOUISVILLE, KY 40207-4341
- **Mailing address phone:** (502) 548-5647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 03/05/2025
- **Last updated:** 04/11/2025