Individual provider Active NPI

Lucie Erlebachova, LMFT

  • Marriage & Family Therapist
  • Louisville, KY
National Provider Identifier
1053548990
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
KY-0792 Issued in KY
Practice address
1100 E Market St
Louisville, KY 40206-1838
Phone
(502) 596-1000
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X KY-0792 KY Primary

Addresses

Primary practice location

1100 E Market St
Louisville, KY 40206-1838

Mailing address

1100 E Market St
Louisville, KY 40206-1838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240422001425 KY Practitioner - Mental Health Counselor 1658710769 Reassigns benefits to 2 organizations
I20260421003918 IN Practitioner - Marriage and Family Therapist 1658710769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mandala House, LLCGroup PAC ID 4789957135, 8 clinicians

Practice addresses (Care Compare)

633 Baxter Ave
Louisville, KY 40204-1157
Phone (502) 309-2408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY-0792KYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mandala House, LLC Marriage & Family Therapist CurrentSince Feb 1, 2024 Accepting new patients

Locations

1190 E Broadway
Louisville, KY 40204
Phone (502) 309-2408

633 Baxter Ave
Louisville, KY 40204
Phone (502) 309-2408

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1053548990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E MARKET ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MARKET ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061838",
            "telephone_number": "502-596-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERLEBACHOVA",
        "first_name": "LUCIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "KY-0792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.