Home Away From Home Therapeutic Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

HOME AWAY FROM HOME THERAPEUTIC CENTER

Practice address

849 S 37TH St
Louisville, KY 40211-2811

Phone

(502) 618-9204

NPI assigned

Nov 22, 2023

Organization subpart

No

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

Authorized official

Name

Shaquila Cooper, DSW, LCSW

Title

Owener/Operator

Phone

(502) 618-9205

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Shaquilla N Cooper, DSW, TCM, LCSW

  • Clinical Social Worker
  • Louisville, KY
  • NPI 1003476466
  NPD

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1548035223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 BOLLING AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402101908",
            "telephone_number": "502-618-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 S 37TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402112811",
            "telephone_number": "502-618-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME AWAY FROM HOME THERAPEUTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "SHAQUILA",
        "authorized_official_title_or_position": "OWENER/OPERATOR",
        "authorized_official_telephone_number": "502-618-9205",
        "authorized_official_credential": "DSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler James Holvey
• Aynsley W Holzen, AU.D.
• Kathryn Ann Holzknecht, PT, DPT
• Kenneth Richard Holzknecht, DMD
• Deborah Homan
• Home Care Oxygen & Equipments L.L.C.
• Home Care With Love LLC
• Home for the Aged of the Little Sisters of the Poor, Inc
• Home Health of Jefferson Co, LLC
• Home Heart LLC

• 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 Nov 22, 2023; 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.