Organization
USPIRITUS.INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT MOORING (VP, REGULATORY AFFAIRS & QI)
(502) 515-0430
Entity
Organization
Contact information
Practice address
3121 BROOKLAWN CAMPUS DR, LOUISVILLE, KY 40218-1282
(502) 451-5177
(502) 451-0896
Mailing address
3121 BROOKLAWN CAMPUS DR, LOUISVILLE, KY 40218-1282
(502) 451-5177
(502) 451-0896
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100254620
—
KY
05
—
7100254660
—
KY
05
—
7100254670
—
KY
05
—
7100254680
—
KY
05
—
7100254690
—
KY
05
—
7100285130
—
KY
Enumeration date
02/17/2015
Last updated
02/17/2015
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