Individual
JENNIFER SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCADC
Contact information
Practice address
161 SAINT MATTHEWS AVE STE 18, LOUISVILLE, KY 40207-3145
(502) 548-5647
Mailing address
907 BROADFIELDS DR, LOUISVILLE, KY 40207-4341
(502) 548-5647
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
164585
KY
1041C0700X
Clinical Social Worker
Primary
3437
KY
Other
Enumeration date
05/17/2007
Last updated
06/27/2024
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