Provider Demographics
NPI:1285011593
Name:BLUEGRASS SOCIAL WORK SERVICES
Entity Type:Organization
Organization Name:BLUEGRASS SOCIAL WORK SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARTHELOW
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:859-825-8747
Mailing Address - Street 1:334 S BROADWAY
Mailing Address - Street 2:UNIT 7
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2552
Mailing Address - Country:US
Mailing Address - Phone:859-825-8747
Mailing Address - Fax:
Practice Address - Street 1:334 S BROADWAY
Practice Address - Street 2:UNIT 7
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2552
Practice Address - Country:US
Practice Address - Phone:859-825-8747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3798OtherSTATE LICENSE