Organization
MINDIVE
Active
Other names
Mindive
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DAVIS (OWNER)
(502) 645-6026
Entity
Organization
Contact information
Practice address
119 S. SHERRIN AVE, STE 240, LOUISVILLE, KY 40207-3237
(502) 509-6002
(502) 415-7263
Mailing address
119 S. SHERRIN AVE, STE 240, LOUISVILLE, KY 40207-3237
(502) 645-6026
(502) 415-7263
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
221700000X
Art Therapist
—
—
Other
Enumeration date
09/23/2022
Last updated
08/07/2025
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