MEDICARE: MARY BADAMI M.A.

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
1	106H00000X	Marriage & Family Therapist	35001660A	IN
2	106H00000X	Marriage & Family Therapist	104043	KY

General Provider Information

NPI Number	:	1568787091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY BADAMI M.A.

Provider Business Mailing Address
First Line	:	2404 WINDSOR FOREST DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40272-2334
Country	:	US
Telephone Number	:	502-548-7873
Fax Number	:	502-384-2299

Provider Business Practice Location Address
First Line	:	2404 WINDSOR FOREST DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40272-4027
Country	:	US
Telephone Number	:	502-548-7873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2010
Last Update Date	:	06/07/2024

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