Organization
HOUSE OF DEMI MENTAL HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEMETRIA TYRAU JANUARY LPCC-NCC (OWNER / CHIEF EXECUTIVE OFFICER)
(502) 641-1877
Entity
Organization
Contact information
Practice address
904 MARLOWS FORD RD APT 201, LOUISVILLE, KY 40245-4779
(502) 641-1877
Mailing address
12123 SHELBYVILLE RD STE 100413, LOUISVILLE, KY 40243-1079
(502) 641-1877
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/19/2022
Last updated
05/17/2023
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