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NPI Code Detail

MEDICARE: MARIAN LANCASTER

MEDICARE:   MARIAN  LANCASTER
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
1101YA0400XAddiction (Substance Use Disorder) CounselorKY-0055KY

General Provider Information

NPI Number : 1902832280
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAN LANCASTER
Provider Business Mailing Address
First Line : 900 AUDUBON PKWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40213-1369
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 914 E BROADWAY
Second Line : STE. 216
City : LOUISVILLE
State : KY
Zip : 40204-1037
Country : US
Telephone Number : 502-584-0044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2006
Last Update Date : 07/08/2007

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Directions to “ MARIAN LANCASTER ” Practice Location

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