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General NPI Number Information
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NPI Number | 1710595905
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Entity Type | Organization
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Legal Business Name | DEFINE YOU COUNSELING SERVICES I DEFINE ME
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 1426 S 28TH ST
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City | LOUISVILLE
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State | KY
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Zip | 40211-1729
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Country | US
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Telephone | 502-500-9443
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Fax | 502-632-1432
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Provider Business Mailing Address
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Address Line | 1205 WINDMILL LN
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-7426
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Country | US
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Telephone | 502-500-9443
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Fax | 502-632-1432
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Authorized Official
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Title or Position | OWNER
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Name | MS. HARVETTA K RAY
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Credential | LCSW
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Telephone | 502-500-9443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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