NPI Code Details Logo

NPI 1497664387

NPI 1497664387 : KINFOLK HEALING COLLECTIVE : LOUISVILLE, KY

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1497664387
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    KINFOLK HEALING COLLECTIVE 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/04/2026
-----------------------------------------------------
    Last Update Date     |    09/23/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    4602 SOUTHERN PKWY STE 1B 
-----------------------------------------------------
    City                 |    LOUISVILLE
-----------------------------------------------------
    State                |    KY
-----------------------------------------------------
    Zip                  |    40214-1442
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    502-678-3161
-----------------------------------------------------
    Fax                  |    502-678-3162
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4602 SOUTHERN PKWY STE 1B 
-----------------------------------------------------
    City                 |    LOUISVILLE
-----------------------------------------------------
    State                |    KY
-----------------------------------------------------
    Zip                  |    40214-1442
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    502-678-3161
-----------------------------------------------------
    Fax                  |    502-678-3162
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     EMILY RAVON FITZPATRICK 
-----------------------------------------------------
    Credential           |    LCSW, LMFT
-----------------------------------------------------
    Telephone            |    502-678-3161
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QM0801X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.