Organization
HOUSE OF MIGHTY MEN OF VALOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONICA LAWRENCE (CREDENTIALING SPECIALIST)
(502) 656-2429
Entity
Organization
Contact information
Practice address
1634 GALLAGHER ST, LOUISVILLE, KY 40210-2435
(502) 269-9604
Mailing address
215 E ORMSBY AVE APT 5, LOUISVILLE, KY 40203-2639
(502) 269-9604
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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