Provider Demographics
NPI:1356866438
Name:MOORMAN, ASHA (LPCC)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:MOORMAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 OEHRLE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-4724
Mailing Address - Country:US
Mailing Address - Phone:502-554-6245
Mailing Address - Fax:
Practice Address - Street 1:3276 COMMERCE CENTER PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-1900
Practice Address - Country:US
Practice Address - Phone:502-554-6245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY244981OtherLPCC
KY171771OtherLICENSED PROFESSIONAL COUNSELOR ASSOCIATE