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NPI Code Detail

MEDICARE: MR. ROBERT D BRILL LCSW

MEDICARE: MR. ROBERT D BRILL LCSW
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
1101YM0800XMental Health CounselorKY-2050KY

General Provider Information

NPI Number : 1952423204
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT D BRILL LCSW
Provider Business Mailing Address
First Line : 1028 BARRET AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1667
Country : US
Telephone Number : 502-451-1221
Fax Number : 502-451-1337
Provider Business Practice Location Address
First Line : 1028 BARRET AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1667
Country : US
Telephone Number : 502-451-1221
Fax Number : 502-451-1337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 07/08/2007

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