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Individual

MR. STANLEY ROBERT BRYANT III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW, LCADC

Contact information

Practice address
234 AMY AVE, LOUISVILLE, KY 40212-2522
(502) 778-0001
Mailing address
234 AMY AVE, LOUISVILLE, KY 40212-2522
(502) 778-0001

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
272984
KY
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
259185
KY
1041C0700X
Clinical Social Worker
34011370A
IN

Other

Enumeration date
03/24/2017
Last updated
09/16/2024
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