Healthcare Provider Details

I. General information

NPI: 1689077836
Provider Name (Legal Business Name): HEIDI SOLARZ-KUTZ, LCSW, CADC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7204 HIGHWAY 329
CRESTWOOD KY
40014-8822
US

IV. Provider business mailing address

7204 HIGHWAY 329
CRESTWOOD KY
40014-8822
US

V. Phone/Fax

Practice location:
  • Phone: 502-457-1823
  • Fax: 502-225-6135
Mailing address:
  • Phone: 502-457-1823
  • Fax: 502-225-6135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number3701
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number1047
License Number StateKY

VIII. Authorized Official

Name: MS. HEIDI LYNN SOLARZ-KUTZ
Title or Position: THERAPIST/SOCIAL WORKER
Credential: LCSW, CADC
Phone: 502-457-1823