Healthcare Provider Details

I. General information

NPI: 1861204661
Provider Name (Legal Business Name): CHAVAY HIBBITT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 S 2ND ST
LOUISVILLE KY
40203-2915
US

IV. Provider business mailing address

3819 ALGONQUIN PKWY
LOUISVILLE KY
40211-2346
US

V. Phone/Fax

Practice location:
  • Phone: 502-409-4238
  • Fax:
Mailing address:
  • Phone: 502-294-1594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: