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Organization

LOUISVILLE MENTAL HEALTH GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY MARIE SULLIVAN LCSW (CLINICAL DIRECTOR)
(502) 417-2299
Entity
Organization

Contact information

Practice address
4229 BARDSTOWN RD STE 322, LOUISVILLE, KY 40218-3241
(502) 417-2299
(502) 888-9771
Mailing address
4229 BARDSTOWN RD STE 322, LOUISVILLE, KY 40218-3241
(502) 417-2299
(502) 888-9771

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3275
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100307100
KY
Enumeration date
03/30/2018
Last updated
06/10/2022
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