Provider Demographics
NPI:1225658859
Name:LISA C. STEELSMITH, PSY.D., PLLC
Entity Type:Organization
Organization Name:LISA C. STEELSMITH, PSY.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEELSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:502-645-3435
Mailing Address - Street 1:200 S BAYLY AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2582
Mailing Address - Country:US
Mailing Address - Phone:502-645-3435
Mailing Address - Fax:502-305-2115
Practice Address - Street 1:4010 DUPONT CIR STE 574
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4843
Practice Address - Country:US
Practice Address - Phone:502-309-9255
Practice Address - Fax:502-305-2115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty