# TELOS HEALTH SYSTEMS KY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Vitae Health Medical Kentucky LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629600879
- **Authorized official:** PETER STEVEN BAILEY (CEO)
- **Authorized official phone:** (609) 480-0119

## Contact information

- **Practice address:** 3500 GOOD SAMARITAN WAY, LOUISVILLE, KY 40299-6117
- **Practice address phone:** (201) 217-6777
- **Mailing address:** 980 SYLVAN AVE FL 2, ENGLEWOOD CLIFFS, NJ 07632-3320
- **Mailing address phone:** (201) 217-6777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/06/2020
- **Last updated:** 08/31/2026