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Organization
HOUSE OF DEMI MENTAL HEALTH AND WELLNESS
Active
Organization
HOUSE OF DEMI MENTAL HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEMETRIA TYRAU JANUARY LPCC-NCC (OWNER / CHIEF EXECUTIVE OFFICER)
(502) 641-1877
Entity
Organization
Contact information
Practice address
904 MARLOWS FORD RD APT 201, LOUISVILLE, KY 40245-4779
(502) 641-1877
Mailing address
12123 SHELBYVILLE RD STE 100413, LOUISVILLE, KY 40243-1079
(502) 641-1877
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/19/2022
Last updated
05/17/2023
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