Provider Demographics
NPI:1649512047
Name:SAFARI KIDZ KOUNSELING LLC
Entity type:Organization
Organization Name:SAFARI KIDZ KOUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-314-2237
Mailing Address - Street 1:11212 SAND LAKE CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272-4382
Mailing Address - Country:US
Mailing Address - Phone:502-314-2237
Mailing Address - Fax:
Practice Address - Street 1:10300 BROOKRIDGE VILLAGE BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-4474
Practice Address - Country:US
Practice Address - Phone:502-314-2237
Practice Address - Fax:844-379-5157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-23
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty