MEDICARE: MS. KATHLEEN LOUISE LITZENBERGER LCSW, ACSW DCSW

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	1041C0700X	Clinical Social Worker	254467	KY
2	1041C0700X	Clinical Social Worker	C003903	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
12	K0010566	OTHER	KY	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1598747610	OTHER	NC	OPTUM
2	6329720	OTHER		CIGNA
3	134NF	OTHER	NC	BLUE CROSS BLUE SHIELD
4	1598747610	OTHER	NC	UBH
5	1598747610	OTHER	NC	CHOICE CARE
6	1598747610	OTHER	NC	HUMANA
7	134-NF	OTHER	NC	ANTHEM
8	1598757610	OTHER	NC	CHOICE CARE
9	331055	OTHER		TRICARE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598747610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN LOUISE LITZENBERGER LCSW, ACSW DCSW

Provider Business Mailing Address
First Line	:	4506 YAGER LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40241-1723
Country	:	US
Telephone Number	:	336-686-2157
Fax Number	:

Provider Business Practice Location Address
First Line	:	7204 HIGHWAY 329 STE 102
Second Line	:
City	:	CRESTWOOD
State	:	KY
Zip	:	40014-8875
Country	:	US
Telephone Number	:	336-686-2157
Fax Number	:

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	06/20/2024

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