Provider Demographics
NPI:1760121446
Name:SABELHAUS-THOMPSON, KAYCIE (LMSW)
Entity Type:Individual
Prefix:
First Name:KAYCIE
Middle Name:
Last Name:SABELHAUS-THOMPSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 PARK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-4924
Mailing Address - Country:US
Mailing Address - Phone:812-319-8399
Mailing Address - Fax:
Practice Address - Street 1:919 BACK RIVER NECK RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-1923
Practice Address - Country:US
Practice Address - Phone:443-596-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26834104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5862732OtherCIGNA
MDFG84000OtherCARE FIRST BLUE CROSS BLUE SHIELD