Provider Demographics
NPI:1184896557
Name:ST LUKE FAMILY BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:ST LUKE FAMILY BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CODER/ABSTRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:859-261-3700
Mailing Address - Street 1:7370 TURFWAY RD STE 350
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4896
Mailing Address - Country:US
Mailing Address - Phone:859-212-4889
Mailing Address - Fax:859-212-4890
Practice Address - Street 1:7370 TURFWAY RD STE 350
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4896
Practice Address - Country:US
Practice Address - Phone:859-212-4889
Practice Address - Fax:859-212-4890
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST LUKE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-26
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY340572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65915621Medicaid
KY9234OtherMEDICARE GROUP