# MOHAMMAD A. MIAN, MD PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KENTUCKIANA PSYCHOTHERAPY ASSOCIATES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639399249
- **Authorized official:** MRS. JACQUELINE JACOBS SINGER (OFFICE MANAGER)
- **Authorized official phone:** (502) 499-9993

## Contact information

- **Practice address:** 9017 TAYLORSVILLE RD, LOUISVILLE, KY 40299-1749
- **Practice address phone:** (502) 499-9993
- **Practice address fax:** (502) 495-0758
- **Mailing address:** 9017 TAYLORSVILLE RD, LOUISVILLE, KY 40299-1749
- **Mailing address phone:** (502) 499-9993
- **Mailing address fax:** (502) 495-0758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 425 | KY | — |
| 174400000X | Specialist | 22242 | KY | Yes |

## Other

- **Enumeration date:** 04/26/2007
- **Last updated:** 03/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100116470 | — | IN |
| 05 | — | 200055430 | — | IN |
| 05 | — | 64222425 | — | KY |
| 05 | — | 65917932 | — | KY |
| 05 | — | 82004250 | — | KY |
| 05 | — | 82900036 | — | KY |