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NPI Code Detail

MEDICARE: JAMI IRVINE-SANDERS

MEDICARE: JAMI IRVINE-SANDERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW00001606KY

General Provider Information

NPI Number : 1114708930
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMI IRVINE-SANDERS
Provider Business Mailing Address
First Line : 7002 URANUS DR
Second Line :
City : LOUISVILLE
State : KY
Zip : 40258-3455
Country : US
Telephone Number : 502-714-8805
Fax Number :
Provider Business Practice Location Address
First Line : 5115 S 3RD ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40214-2601
Country : US
Telephone Number : 812-248-9206
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2023
Last Update Date : 06/04/2026

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Directions to “ JAMI IRVINE-SANDERS ” Practice Location

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