Organization
LOUISVILLE PSYCHOTHERAPY GROUP, LLC
Active
Organization
LOUISVILLE PSYCHOTHERAPY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC RUSS PH.D. (OWNER)
(404) 290-7916
Entity
Organization
Contact information
Practice address
1711 BARDSTOWN RD STE 202, LOUISVILLE, KY 40205-2258
(502) 208-8794
Mailing address
2239 1/2 TALBOTT AVE, LOUISVILLE, KY 40205-2271
(404) 290-7916
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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