Provider Demographics
NPI:1467517342
Name:MONA CATTAN-LEWIS LLC
Entity Type:Organization
Organization Name:MONA CATTAN-LEWIS LLC
Other - Org Name:INTERWOVEN WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:CATTAN-LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-451-6662
Mailing Address - Street 1:1617 EASTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1561
Mailing Address - Country:US
Mailing Address - Phone:502-451-6662
Mailing Address - Fax:502-451-6665
Practice Address - Street 1:1562 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1155
Practice Address - Country:US
Practice Address - Phone:502-451-6662
Practice Address - Fax:502-451-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-13551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000201848OtherANTHEM IW