THERESA FAUTZ LCSW NPI 1447345038

NPI Information

NPI: 1447345038
Provider Name: THERESA FAUTZ, LCSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
1448 GARDINER LN
SUITE202-203
LOUISVILLE, KY
ZIP 40213
Phone: (502) 456-9998
Get Directions

Theresa Fautz, LCSW is a mental health counselor in Louisville, KY. Theresa Fautz, LCSW NPI is 1447345038. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1448 GARDINER LN
SUITE202-203
LOUISVILLE, KY
ZIP 40213-978
Phone: (502) 456-9998
Fax: (502) 456-9923

The enumeration date for this NPI number is 10/3/2006 and was last updated on 5/22/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	KY1617	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	82001066	MEDICAID	KENTUCKY
2	CSW0281	MEDICARE ID-TYPE UNSPECIFIED	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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