Healthcare Provider Details

I. General information

NPI: 1104859255
Provider Name (Legal Business Name): GRETCHEN L RINEHART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8011 NEW LA GRANGE RD STE 7
LOUISVILLE KY
40222-4781
US

IV. Provider business mailing address

9612 HUNTING GROUND CT
LOUISVILLE KY
40228-2485
US

V. Phone/Fax

Practice location:
  • Phone: 502-876-4184
  • Fax: 502-780-5898
Mailing address:
  • Phone: 502-876-4184
  • Fax: 502-780-5898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2030
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2030
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: