Healthcare Provider Details

I. General information

NPI: 1750039343
Provider Name (Legal Business Name): JENNY AMY HOHMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4112 FERN VALLEY RD
LOUISVILLE KY
40219-1973
US

IV. Provider business mailing address

114 WAVERLY CT
LOUISVILLE KY
40206-2040
US

V. Phone/Fax

Practice location:
  • Phone: 502-964-2699
  • Fax:
Mailing address:
  • Phone: 502-645-9172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number256535
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: