Provider Demographics
NPI:1871643049
Name:DIGIOVANNI, SALLY FAITH (MS LMFT)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:FAITH
Last Name:DIGIOVANNI
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:MS
Other - First Name:SALLY
Other - Middle Name:FAITH
Other - Last Name:HENDRICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS LMFT
Mailing Address - Street 1:7400 NEW LA GRANGE RD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222
Mailing Address - Country:US
Mailing Address - Phone:502-423-1975
Mailing Address - Fax:502-423-9836
Practice Address - Street 1:7400 NEW LA GRANGE RD
Practice Address - Street 2:SUITE 315
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222
Practice Address - Country:US
Practice Address - Phone:502-423-1975
Practice Address - Fax:502-423-9836
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0066106H00000X
CA20724106H00000X
IN35001128A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist