Organization
A SAFE PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN DIEMER LCSW (THERAPIST)
(502) 593-3831
Entity
Organization
Contact information
Practice address
4229 BARDSTOWN RD STE 214, LOUISVILLE, KY 40218-3241
(502) 630-2018
(502) 630-2018
Mailing address
4229 BARDSTOWN RD STE 214, LOUISVILLE, KY 40218-3241
(502) 630-2018
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100576900
—
KY
Enumeration date
07/10/2021
Last updated
08/30/2021
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