Louisville Mental Health Group

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3275 Issued in KY

Legal business name

LOUISVILLE MENTAL HEALTH GROUP

Practice address

4229 Bardstown Rd Ste 322
Louisville, KY 40218-3241

Phone

(502) 417-2299

Fax

(502) 888-9771

NPI assigned

Mar 30, 2018

Organization subpart

No

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

Authorized official

Name

Kimberly Marie Sullivan, LCSWNPI 1750704789

Title

Clinical Director

Phone

(502) 417-2299

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kimberly Sullivan, LCSW

  • Clinical Social Worker
  • Louisville, KY
  • NPI 1750704789
  NPD Authorized official

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1386140358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 BARDSTOWN RD STE 322",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402183241",
            "telephone_number": "502-417-2299",
            "fax_number": "502-888-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 BARDSTOWN RD STE 322",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402183241",
            "telephone_number": "502-417-2299",
            "fax_number": "502-888-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE MENTAL HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "502-417-2299",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100307100",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louisville Ky Opco LLC
• Louisville Ky Opco LLC
• Louisville Lung Care PLLC
• Louisville Mammography Associates PSC
• Louisville Medical Associates
• Louisville Mental Health Services, Co
• Louisville Metro Chiropractic
• Louisville Metro Government
• Louisville Metro Recovery
• Louisville Mind and Wellness

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.