Eva Archie
Individual provider Active NPI Marriage & Family Therapist · Louisville, KY
NPI 1194144956 · NPPES record last updated Jan 20, 2023
Key facts
- NPI
- 1194144956
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 162990 (KY)
- Practice address
- 3934 Dixie Hwy Ste 330
Louisville, KY 40216-4170 - Phone
- (502) 409-4357
- Fax
- (502) 873-5048
- NPI assigned
- Apr 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164871 | KY | MD | Addiction (Substance Use Disorder) Counselor |
| 162990 | KY | MD | Marriage & Family Therapist |
| 4101007322 | MI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 1St Choice PLLC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
| Pops House | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
3934 Dixie Hwy
Ste 330
Louisville, KY 40216
Phone (502) 409-4357
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 164871 | KY | |
| Marriage & Family Therapist | 106H00000X | |||
| Marriage & Family Therapist | 106H00000X | 4101007322 | MI | |
| Peer Specialist | 175T00000X | KY | ||
| Community/Behavioral Health Agency | 251S00000X | |||
| Marriage & Family Therapist | 106H00000X | 162990 | KY | Yes |
Addresses
Primary practice location
3934 Dixie Hwy Ste 330
Louisville, KY 40216-4170
Mailing address
3934 Dixie Hwy
Ste 330
Louisville, KY 40216-4170
Phone (502) 409-4357
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100381410 | Medicaid | KY |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | empoweredbychoices@outlook.com |
Other providers in Louisville, KY
- Elisa Anne Archer
- Johanna Suzanne Archer
- Katherine M Archer
- Alexis La'Shea Archibald
- James Archibald
- Arden Courts of Louisville Ky LLC
- Brenda Arellano
- Paul J Arena
- Arenas Logistics LLC
- Julie Marie Aria
All providers in Louisville, KY · Marriage & Family Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.