Individual provider Active NPI

Jennifer S O'Loughlin, LCSW

  • Mental Health Counselor
  • Louisville, KY
National Provider Identifier
1174621072
Registry record updated Dec 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1387 Issued in KY
Practice address
9700 Park Plaza Ave Unit 105
Louisville, KY 40241-2286
Phone
(502) 802-1691
Fax
(502) 426-4902
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1387 KY Primary

Addresses

Primary practice location

9700 Park Plaza Ave Unit 105
Louisville, KY 40241-2286

Mailing address

9700 Park Plaza Ave Unit 105
Louisville, KY 40241-2286
Phone (502) 802-1691

Other identifiers 1

IdentifierTypeStateIssuer
610444704OtherKYTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1387KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bailey & Associates PSC CurrentSince Dec 29, 2019 Accepting new patients
Jewish Family & Career Services of Louisville Inc Mental Health PastSince Jan 1, 2005 Accepting new patients

Locations

9700 Park Plaza Ave
Unit 105
Louisville, KY 40241
Phone (502) 327-0209

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577577600000",
    "number": "1174621072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 PARK PLAZA AVE UNIT 105",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412286",
            "telephone_number": "502-802-1691",
            "fax_number": "502-426-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 PARK PLAZA AVE UNIT 105",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412286",
            "telephone_number": "502-802-1691",
            "fax_number": "502-426-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LOUGHLIN",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-12-29",
        "certification_date": "2019-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "1387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "610444704",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.