Provider Demographics
NPI:1770518375
Name:PODBELSEK, JEAN (LCSW)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:PODBELSEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 SPRINGHURST BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-6137
Mailing Address - Country:US
Mailing Address - Phone:502-394-0101
Mailing Address - Fax:502-425-4275
Practice Address - Street 1:3801 SPRINGHURST BLVD
Practice Address - Street 2:STE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-6137
Practice Address - Country:US
Practice Address - Phone:502-423-7222
Practice Address - Fax:502-423-7277
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY4921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical