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General NPI Number Information
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NPI Number | 1750533626
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Entity Type | Organization
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Legal Business Name | TRIUNE COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 2303 HURSTBOURNE VILLAGE DR STE 1100
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City | LOUISVILLE
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State | KY
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Zip | 40299-1830
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Country | US
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Telephone | 502-387-8802
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Fax | 502-618-2875
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Provider Business Mailing Address
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Address Line | 2303 HURSTBOURNE VILLAGE DR STE 1100
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City | LOUISVILLE
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State | KY
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Zip | 40299-1830
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Country | US
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Telephone | 502-387-8802
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Fax | 502-618-2875
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Authorized Official
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Title or Position | SOLE MEMBER-OWNER
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Name | MR. MICHAEL BRUCE TAYLOR
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Credential | LMFT
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Telephone | 502-387-8802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | KY-0453MFT
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License Number State | KY
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