Individual
DEVON FAHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
645 S ROY WILKINS AVE STE 100, LOUISVILLE, KY 40203-2072
(502) 583-4092
(502) 371-6110
Mailing address
2020 NEWBURG RD, LOUISVILLE, KY 40205-1803
(502) 601-7085
(502) 479-4259
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
257865
KY
1041C0700X
Clinical Social Worker
Primary
7520
KY
405300000X
Prevention Professional
7520
KY
Other
Enumeration date
05/17/2017
Last updated
07/05/2024
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