Provider Demographics
NPI:1851730956
Name:DSDMD, LTD
Entity Type:Organization
Organization Name:DSDMD, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DARROW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-899-2077
Mailing Address - Street 1:6601 BROWNSBORO PARK BLD
Mailing Address - Street 2:STE G
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-1292
Mailing Address - Country:US
Mailing Address - Phone:502-899-2077
Mailing Address - Fax:502-899-2164
Practice Address - Street 1:6601 BROWNSBORO PARK BLD
Practice Address - Street 2:SUITE G
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-1292
Practice Address - Country:US
Practice Address - Phone:502-899-2077
Practice Address - Fax:502-899-2164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty