Healthcare Provider Details

I. General information

NPI: 1659686756
Provider Name (Legal Business Name): AVIS S FLEMING LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AVIS SALTER

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 SPENCER CT
LA GRANGE KY
40031-6742
US

IV. Provider business mailing address

10401 LINN STATION RD STE 100
LOUISVILLE KY
40223-3842
US

V. Phone/Fax

Practice location:
  • Phone: 502-589-8600
  • Fax: 502-589-8771
Mailing address:
  • Phone: 502-589-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number308164
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: