Provider Demographics
NPI:1750428595
Name:HOWARD, CHRISTY (LCSW, RPT-S)
Entity type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LCSW, RPT-S
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:DELAQUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
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:844-379-5157
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004876A1041C0700X
KY32741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100270550Medicaid