Provider Demographics
NPI:1780093559
Name:SANCHEZ, JAMIE (CSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 JEPTHA KNOB RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-9428
Mailing Address - Country:US
Mailing Address - Phone:502-454-6343
Mailing Address - Fax:502-459-9209
Practice Address - Street 1:4710 CHAMPIONS TRACE
Practice Address - Street 2:#107
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218
Practice Address - Country:US
Practice Address - Phone:502-454-6343
Practice Address - Fax:502-459-9209
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD70671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical