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Organization

COMMUNITY SUPPORT OUTREACH AGENCY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LASHONDA ROBERTSON (OWNER)
(502) 612-5495
Entity
Organization

Contact information

Practice address
1827 W BROADWAY, LOUISVILLE, KY 40203-3547
(502) 963-5792
(502) 653-7063
Mailing address
11126 COMPASS AVE, LOUISVILLE, KY 40229-8391
(502) 612-5495
(502) 653-7063

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
171M00000X
Case Manager/Care Coordinator
Primary
175T00000X
Peer Specialist
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
261QM1300X
Multi-Specialty Clinic/Center

Other

Enumeration date
08/20/2025
Last updated
08/20/2025
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