Healthcare Provider Details

I. General information

NPI: 1790139400
Provider Name (Legal Business Name): ACCESS COMMUNITY ASSISTANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 SAINT MATTHEWS AVE SUITE 9
LOUISVILLE KY
40207-3137
US

IV. Provider business mailing address

159 SAINT MATTHEWS AVE SUITE 9
LOUISVILLE KY
40207-3137
US

V. Phone/Fax

Practice location:
  • Phone: 502-899-7105
  • Fax: 502-899-1403
Mailing address:
  • Phone: 502-899-7105
  • Fax: 502-899-1403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XR0403X
TaxonomyDriving and Community Mobility Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: SUSAN B. STOKES
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential:
Phone: 502-899-7105