Healthcare Provider Details

I. General information

NPI: 1265946859
Provider Name (Legal Business Name): YOLONDA J ARMSTEAD LCSW, LCADC-S, CCTP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2017
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4122 WAHL STREET BLVD STE 15
LOUISVILLE KY
40218-3265
US

IV. Provider business mailing address

18 VILLAGE PLZ # 218
SHELBYVILLE KY
40065-1745
US

V. Phone/Fax

Practice location:
  • Phone: 502-290-1288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number252443
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number256264
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: