MEDICARE: ACCESS COMMUNITY ASSISTANCE, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist
3	251B00000X	Case Management Agency
4	251C00000X	Developmentally Disabled Services Day Training Agency
5	251S00000X	Community/Behavioral Health Agency
6	103T00000X	Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881872091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS COMMUNITY ASSISTANCE, INC.

Provider Business Mailing Address
First Line	:	159 SAINT MATTHEWS AVE
Second Line	:	SUITE 10
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-3137
Country	:	US
Telephone Number	:	502-899-3205
Fax Number	:	502-899-7105

Provider Business Practice Location Address
First Line	:	159 SAINT MATTHEWS AVE
Second Line	:	SUITE 10
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-3137
Country	:	US
Telephone Number	:	502-899-3205
Fax Number	:	502-899-7105

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. SUSAN B. STOKES
Credential	:
Telephone Number	:	502-899-3205

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	06/06/2008

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