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General NPI Number Information
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NPI Number | 1215165626
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Entity Type | Organization
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Legal Business Name | NORTHEAST CHRISTIAN CHURCH
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 4601 CHAMBERLAIN LN
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City | LOUISVILLE
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State | KY
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Zip | 40241-1159
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Country | US
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Telephone | 502-212-0432
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Fax | 502-212-0454
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Provider Business Mailing Address
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Address Line | 4601 CHAMBERLAIN LANE NORTH SPRINGS COUNSELING SERVICES
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City | LOUISVILLE
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State | KY
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Zip | 40241-1159
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Country | US
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Telephone | 502-212-0432
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Fax | 502-212-0454
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Authorized Official
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Title or Position | DIRECTOR OF COUNSELING
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Name | MR. JOSEPH SMITH ARNOLD
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Credential | LPCC
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Telephone | 502-212-0432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0027
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License Number State | KY
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