Individual
VANESSA LIN TIRABASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA, LCADC
Contact information
Practice address
2141 SPENCER CT, LA GRANGE, KY 40031-6742
(502) 589-8600
Mailing address
10401 LINN STATION RD STE 100, LOUISVILLE, KY 40223-3842
(502) 589-8600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
267310
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
282223
KY
103T00000X
Psychologist
245804
KY
103TC0700X
Clinical Psychologist
266181
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
04/09/2019
Last updated
02/22/2023
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