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NPI Code Detail

MEDICARE: LIONHEART COMMUNITY SUPPORT SERVICES

MEDICARE: LIONHEART COMMUNITY SUPPORT SERVICES
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 Worker

General Provider Information

NPI Number : 1295427714
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIONHEART COMMUNITY SUPPORT SERVICES
Provider Business Mailing Address
First Line : 3147 CUSTER DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40517-4020
Country : US
Telephone Number : 859-314-8786
Fax Number :
Provider Business Practice Location Address
First Line : 3147 CUSTER DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40517-4020
Country : US
Telephone Number : 859-314-8786
Fax Number :
Authorized Official
Title or Position : CEO
Name : KATHERINE PENNINGTON
Credential : LCSW
Telephone Number : 859-314-8786
Provider Enumeration Date : 05/23/2023
Last Update Date : 05/23/2023

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Directions to “LIONHEART COMMUNITY SUPPORT SERVICES ” Practice Location

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