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Individual

MR. JASON SCOTT UNDERHILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BSW, ICADC

Contact information

Practice address
214 E BRECKINRIDGE ST, LOUISVILLE, KY 40203
(812) 653-1908
(502) 371-0829
Mailing address
214 E BRECKINRIDGE ST, LOUISVILLE, KY 40203
(812) 653-1908
(502) 371-0829

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1187
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1187
PUBLIC PROTECTION CABINET
KY
Enumeration date
01/24/2014
Last updated
01/24/2014
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