Healthcare Provider Details

I. General information

NPI: 1699370866
Provider Name (Legal Business Name): NATALIE MARIE WARREN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 BINGHAM VIEW CT
PROSPECT KY
40059-8688
US

IV. Provider business mailing address

9100 BINGHAM VIEW CT
PROSPECT KY
40059-8688
US

V. Phone/Fax

Practice location:
  • Phone: 502-432-1111
  • Fax:
Mailing address:
  • Phone: 502-432-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number282057
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: