1841350279 NPI number — MRS. ELIZABETH BRINSON SENN LCSW BCD

Table of content: MRS. ELIZABETH BRINSON SENN LCSW BCD (NPI 1841350279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841350279 NPI number — MRS. ELIZABETH BRINSON SENN LCSW BCD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SENN
Provider First Name:
ELIZABETH
Provider Middle Name:
BRINSON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW BCD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841350279
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1169 EASTERN PARKWAY
Provider Second Line Business Mailing Address:
MEDICAL ARTS BLDG SUITE 411
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-473-7028
Provider Business Mailing Address Fax Number:
502-454-0666

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1169 EASTERN PARKWAY
Provider Second Line Business Practice Location Address:
MEDICAL ARTS BLDG SUITE 411
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-473-7028
Provider Business Practice Location Address Fax Number:
502-454-0666
Provider Enumeration Date:
12/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  426 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 82004268 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 426 . This is a "LCSW LICENSE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".