Provider Demographics
NPI:1346867447
Name:ESPINOSA, DILLON (LPCC)
Entity Type:Individual
Prefix:
First Name:DILLON
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 GOSS AVE APT 1303
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-2276
Mailing Address - Country:US
Mailing Address - Phone:980-297-6174
Mailing Address - Fax:
Practice Address - Street 1:119 S SHERRIN AVE STE 230
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3237
Practice Address - Country:US
Practice Address - Phone:502-701-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15729101YM0800X
KY283989101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty