Organization
LOUISVILLE INTEGRATED CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE R HICKS CADC (OWNER)
(502) 612-6981
Entity
Organization
Contact information
Practice address
1151 S 4TH ST STE 208, LOUISVILLE, KY 40203-3101
(502) 612-6981
Mailing address
1151 S 4TH ST STE 208, LOUISVILLE, KY 40203-3101
(502) 612-6981
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
05/01/2020
Last updated
07/09/2020
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