Provider Demographics
NPI:1922399302
Name:SHIRLEY, LETITIA F (LPCC)
Entity Type:Individual
Prefix:MS
First Name:LETITIA
Middle Name:F
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MS
Other - First Name:LETITIA
Other - Middle Name:F
Other - Last Name:SHIRLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:101 W MUHAMMAD ALI BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1423
Mailing Address - Country:US
Mailing Address - Phone:502-589-8600
Mailing Address - Fax:
Practice Address - Street 1:7511 NEW LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4859
Practice Address - Country:US
Practice Address - Phone:502-423-1151
Practice Address - Fax:502-423-1748
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional