Provider Demographics
NPI:1649779778
Name:DOUB COUNSELING LLC
Entity Type:Organization
Organization Name:DOUB COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUB
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-396-0529
Mailing Address - Street 1:3001 ROSEDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1809
Mailing Address - Country:US
Mailing Address - Phone:502-396-0529
Mailing Address - Fax:
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:502-396-0529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty