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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