Healthcare Provider Details

I. General information

NPI: 1457108300
Provider Name (Legal Business Name): JOELENE E KURTZ LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HIGHLAND AVE
CARROLLTON KY
41008-8770
US

IV. Provider business mailing address

720 W BROADWAY STE 202
LOUISVILLE KY
40202-3245
US

V. Phone/Fax

Practice location:
  • Phone: 502-316-6675
  • Fax: 502-371-6110
Mailing address:
  • Phone: 502-583-4092
  • Fax: 502-371-6110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number266922
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: