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General NPI Number Information
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NPI Number | 1306975560
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Entity Type | Individual
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Provider Name | DAVID BIRDWHISTELL LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 09/20/2010
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Provider Practice Location Address
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Address Line | KADEN TOWER STE 303 6100 DUTCHMAN'S LANE
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City | LOUISVILLE
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State | KY
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Zip | 40205-3284
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Country | US
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Telephone | 502-896-1850
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Fax | 502-896-6863
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Provider Business Mailing Address
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Address Line | 4701 S RUTLAND AVE
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City | LOUISVILLE
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State | KY
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Zip | 40215-2461
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Country | US
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Telephone | 502-235-3334
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 4875
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3399
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License Number State | KY
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