Provider Demographics
NPI:1659611598
Name:GAUSS, MARILYN KAY (MA, LMFT, LPCA)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:KAY
Last Name:GAUSS
Suffix:
Gender:F
Credentials:MA, LMFT, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9812 SHELBYVILLE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2906
Mailing Address - Country:US
Mailing Address - Phone:502-423-0509
Mailing Address - Fax:502-423-1599
Practice Address - Street 1:9812 SHELBYVILLE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2906
Practice Address - Country:US
Practice Address - Phone:502-423-0509
Practice Address - Fax:502-423-1599
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1145101YM0800X
KYKY-0820106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health