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General NPI Number Information
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NPI Number | 1376343756
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Entity Type | Organization
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Legal Business Name | KENTUCKY PSYCHIATRIC CARE, PLLC
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Dates
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Enumeration Date | 03/15/2025
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Last Update Date | 03/15/2025
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Provider Practice Location Address
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Address Line | 4175 WESTPORT RD STE 104
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City | LOUISVILLE
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State | KY
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Zip | 40207-2787
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Country | US
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Telephone | 502-830-9330
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Fax | 510-256-0218
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Provider Business Mailing Address
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Address Line | 4175 WESTPORT RD STE 104
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City | LOUISVILLE
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State | KY
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Zip | 40207-2787
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Country | US
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Telephone | 502-830-9330
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Fax | 510-256-0218
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Authorized Official
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Title or Position | PMHNP-BC
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Name | LORRIE S SMITH-ESTERLE
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Credential | DNP
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Telephone | 502-424-5622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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