Kathryn Ann Jacoby
Individual provider Active NPI Social Worker · Louisville, KY
NPI 1245906346 · NPPES record last updated Aug 18, 2021
Key facts
- NPI
- 1245906346
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 10300 Brookridge Village Blvd
Louisville, KY 40291-4474 - Phone
- (502) 785-4322
- NPI assigned
- Aug 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250401001746 | KY | Practitioner - Clinical Social Worker | 9032632989 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brock Family Therapy Center Inc. | Current |
Accepting new patients |
Locations
10300 Brookridge Village Blvd
Ste 104
Louisville, KY 40291
Phone (502) 727-8697
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
10300 Brookridge Village Blvd
Louisville, KY 40291-4474
Mailing address
1602 Lucia Ave
Louisville, KY 40204-1326
Phone (859) 707-4799
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.