NPIMap

Organization Active NPI

MDC2 LLC

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1346431335
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1966 Issued in KY
Legal business name
MDC2 LLC
Practice address
9319 Taylorsville Rd
Louisville, KY 40299-1737
Phone
(502) 618-1201
Fax
(502) 618-2609
NPI assigned
Aug 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Authorized official

Name
Mrs. Marydora Conley, LMFT/LCSW
Title
Clinical Partner
Phone
(502) 618-1201

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 1966 KY Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 0575 KY

Addresses

Primary practice location

9319 Taylorsville Rd
Louisville, KY 40299-1737

Mailing address

9319 Taylorsville Rd
Louisville, KY 40299-1737
Phone (502) 618-1201

Other identifiers 1

IdentifierTypeStateIssuer
1649473133OtherKYINDIVIDUAL NPI

Other names 1

  • Restoration House Doing business as

National Provider Directory

National Provider Directory

Locations

9319 Taylorsville Rd
Louisville, KY 40299
Phone (502) 500-1553

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1346431335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9319 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991737",
            "telephone_number": "502-618-1201",
            "fax_number": "502-618-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9319 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991737",
            "telephone_number": "502-618-1201",
            "fax_number": "502-618-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDC2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "MARYDORA",
        "authorized_official_title_or_position": "CLINICAL PARTNER",
        "authorized_official_telephone_number": "502-618-1201",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT/LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1966",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "0575",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1649473133",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoration House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 23, 2009; 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.