Organization
WALDEN BEHAVIOR SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE SIAS WILKINSON MS, BCBA, LBA (OWNER/EXECUTIVE DIRECTOR)
(502) 915-8796
Entity
Organization
Contact information
Practice address
9900 SHELBYVILLE RD STE 8, LOUISVILLE, KY 40223-2965
(502) 915-8796
(502) 805-0765
Mailing address
9900 SHELBYVILLE RD STE 8, LOUISVILLE, KY 40223-2965
(502) 915-8796
(502) 805-0765
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
101584
KY
251S00000X
Community/Behavioral Health Agency
0906666
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100338500
—
KY
01
—
7100455710
SCL MEDICAID WAIVER
KY
05
—
7100467300
—
KY
Enumeration date
01/12/2015
Last updated
02/09/2022
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