Provider Demographics
NPI:1376343756
Name:KENTUCKY PSYCHIATRIC CARE, PLLC
Entity type:Organization
Organization Name:KENTUCKY PSYCHIATRIC CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:LORRIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH-ESTERLE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:502-424-5622
Mailing Address - Street 1:4175 WESTPORT RD STE 104
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-2787
Mailing Address - Country:US
Mailing Address - Phone:502-830-9330
Mailing Address - Fax:510-256-0218
Practice Address - Street 1:4175 WESTPORT RD STE 104
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-2787
Practice Address - Country:US
Practice Address - Phone:502-830-9330
Practice Address - Fax:510-256-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health