Individual
LAUREN THEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2225 W BROADWAY, LOUISVILLE, KY 40211-1003
(502) 589-8600
(502) 589-8771
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
103601
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100287230
—
KY
Enumeration date
08/12/2010
Last updated
06/06/2016
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