Provider Demographics
NPI:1710675707
Name:WELSH, CHARLES KLEYMEYER (LCSW)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:KLEYMEYER
Last Name:WELSH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 950244
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0244
Mailing Address - Country:US
Mailing Address - Phone:502-953-4700
Mailing Address - Fax:
Practice Address - Street 1:834 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1072
Practice Address - Country:US
Practice Address - Phone:502-583-1981
Practice Address - Fax:502-996-8309
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2525221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical