Individual
MS. GLORIA MARIE EVERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
950 S 1ST ST, LOUISVILLE, KY 40203-2288
(502) 585-9444
(502) 585-9466
Mailing address
950 S 1ST ST, LOUISVILLE, KY 40203-2288
(502) 585-9444
(502) 585-9466
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1143
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000219305
ANTHEM
KY
05
—
9008
—
KY
Enumeration date
01/24/2007
Last updated
07/08/2007
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