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General NPI Number Information
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NPI Number | 1013383884
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Entity Type | Organization
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Legal Business Name | DELTA BEHAVIORAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 2210 GOLDSMITH LN SUITE 204 C
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City | LOUISVILLE
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State | KY
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Zip | 40218-1038
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Country | US
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Telephone | 502-713-2555
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Fax | 888-343-1870
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Provider Business Mailing Address
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Address Line | 9016 TAYLORSVILLE RD #198
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City | LOUISVILLE
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State | KY
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Zip | 40299-1750
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Country | US
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Telephone | 502-713-2555
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Fax | 888-343-1870
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MR. EARL BELL
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Credential | LCSW
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Telephone | 502-713-2555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW 3009
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License Number State | KY
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