Provider Demographics
NPI:1881872091
Name:ACCESS COMMUNITY ASSISTANCE, INC.
Entity type:Organization
Organization Name:ACCESS COMMUNITY ASSISTANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-899-3205
Mailing Address - Street 1:159 SAINT MATTHEWS AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3137
Mailing Address - Country:US
Mailing Address - Phone:502-899-3205
Mailing Address - Fax:502-899-7105
Practice Address - Street 1:159 SAINT MATTHEWS AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3137
Practice Address - Country:US
Practice Address - Phone:502-899-3205
Practice Address - Fax:502-899-7105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY17000894Medicaid