Organization
AVA HEALTH AND WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BERGHAUSEN (OWNER)
(502) 558-0916
Entity
Organization
Contact information
Practice address
417 BENJAMIN LN STE 101, LOUISVILLE, KY 40222-4939
(502) 289-9306
Mailing address
6376 CLORE LN, CRESTWOOD, KY 40014-8042
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/12/2023
Last updated
09/20/2023
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