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Organization

GREATER LOUISVILLE COUNSELING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH L MCKENZIE (EXECUTIVE DIRECTOR)
(502) 587-9737
Entity
Organization

Contact information

Practice address
332 W BROADWAY, SUITE 905, LOUISVILLE, KY 40202-2130
(502) 587-9737
Mailing address
332 W BROADWAY, SUITE 905, LOUISVILLE, KY 40202-2130
(502) 587-9737

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
800150
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100323580
KY
Enumeration date
09/01/2015
Last updated
09/01/2015
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