Provider Demographics
NPI:1013505387
Name:THE ZEN DEN, LLC
Entity Type:Organization
Organization Name:THE ZEN DEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KNAUER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-553-1236
Mailing Address - Street 1:4211 POPLAR LEVEL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-1527
Mailing Address - Country:US
Mailing Address - Phone:502-805-1121
Mailing Address - Fax:
Practice Address - Street 1:4211 POPLAR LEVEL RD STE 101
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-1527
Practice Address - Country:US
Practice Address - Phone:502-805-1121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty