Individual
MICHAEL ABBOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8426
(606) 523-8521
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4900
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0641
KY
1041C0700X
Clinical Social Worker
Primary
1965
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100317660
—
KY
01
—
P01458979
RR MEDICARE
KY
Enumeration date
05/23/2007
Last updated
12/01/2020
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