Provider Demographics
NPI:1154448645
Name:LOUISVILLE COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LOUISVILLE COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:R
Authorized Official - Last Name:VAVRO
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:502-495-1888
Mailing Address - Street 1:PO BOX 18083
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40261-0083
Mailing Address - Country:US
Mailing Address - Phone:502-495-1888
Mailing Address - Fax:502-495-7515
Practice Address - Street 1:4229 BARDSTOWN RD
Practice Address - Street 2:102
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3241
Practice Address - Country:US
Practice Address - Phone:502-495-1888
Practice Address - Fax:502-495-7515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0811101YP2500X
KY19001041C0700X
KY13291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty