Organization
THERAPEUTIC INTERVENTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LILI S. LUTGENS LCSW (MEMBER)
(502) 762-6258
Entity
Organization
Contact information
Practice address
9900 CORPORATE CAMPUS DR, LOUISVILLE, KY 40223-4050
(502) 762-6258
Mailing address
4303 EMERALD WAY, NEW ALBANY, IN 47150-9330
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7100225100
KY
103K00000X
Behavior Analyst
7100225100
KY
103TC0700X
Clinical Psychologist
7100225100
KY
103TM1800X
Intellectual & Developmental Disabilities Psychologist
7100225100
KY
1041C0700X
Clinical Social Worker
7100225100
KY
106H00000X
Marriage & Family Therapist
7100225100
KY
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
225100000X
Physical Therapist
7100225100
KY
225X00000X
Occupational Therapist
7100225100
KY
235Z00000X
Speech-Language Pathologist
7100225100
KY
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100225100
—
KY
Enumeration date
04/28/2012
Last updated
04/16/2024
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