Provider Demographics
NPI:1023358389
Name:WISDOM OF THE HEART, INC.
Entity Type:Organization
Organization Name:WISDOM OF THE HEART, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:859-338-8720
Mailing Address - Street 1:535 W SECOND ST STE 207
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1268
Mailing Address - Country:US
Mailing Address - Phone:859-338-8720
Mailing Address - Fax:859-255-5385
Practice Address - Street 1:535 W SECOND ST STE 207
Practice Address - Street 2:SUITE 207
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1268
Practice Address - Country:US
Practice Address - Phone:859-338-8720
Practice Address - Fax:859-255-5385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0059251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health