Healthcare Provider Details

I. General information

NPI: 1538073424
Provider Name (Legal Business Name): LILIANA TINSLEY CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 CHAMPION WAY STE 11
GEORGETOWN KY
40324-8862
US

IV. Provider business mailing address

8720 LANTERN LITE PKWY
LOUISVILLE KY
40220-2914
US

V. Phone/Fax

Practice location:
  • Phone: 502-603-0020
  • Fax:
Mailing address:
  • Phone: 502-694-2887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCSW00001037
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: