Organization
LOUISVILLE BEHAVIORAL HEALTH SYSTEMS PLLC
Active
Organization
LOUISVILLE BEHAVIORAL HEALTH SYSTEMS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EVELYN ROSE ZWANZIG (CREDENTIALING SPECIALIST)
(502) 454-8800
Entity
Organization
Contact information
Practice address
3430 NEWBURG RD, SUITE 210, LOUISVILLE, KY 40218-2497
(502) 454-8800
(502) 736-0140
Mailing address
3430 NEWBURG RD, SUITE 210, LOUISVILLE, KY 40218-2497
(502) 454-8800
(502) 736-0140
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100041560
—
KY
05
—
7100152610
—
KY
Enumeration date
08/31/2006
Last updated
07/22/2021
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