Organization
INITIATIVE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN GAGE LPCC (OWNER)
(503) 348-4640
Entity
Organization
Contact information
Practice address
1169 EASTERN PKWY STE 2239, LOUISVILLE, KY 40217-1444
(502) 509-5628
Mailing address
1169 EASTERN PKWY STE 2239, LOUISVILLE, KY 40217-1444
(503) 348-4640
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/03/2024
Last updated
12/10/2024
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