Individual
JAMES SILLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 772-8189
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 772-8189
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3598
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100303460
—
KY
Enumeration date
07/21/2008
Last updated
09/23/2014
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