Healthcare Provider Details

I. General information

NPI: 1730288630
Provider Name (Legal Business Name): CHERYLLE LYNNE TROUT MSSW CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERYLLE LYNNE COLUMBER

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ZORN AVENUE VAMC
LOUISVILLE KY
40206
US

IV. Provider business mailing address

1765 KINGS CHURCH ROAD
TAYLORSVILLE KY
40071
US

V. Phone/Fax

Practice location:
  • Phone: 502-287-4000
  • Fax: 502-287-6197
Mailing address:
  • Phone: 502-538-0782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberKY4853
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: