Provider Demographics
NPI:1902061740
Name:WERTS, MICHELE NICOLE (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:NICOLE
Last Name:WERTS
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 1:12701 TOWNEPARK WAY
Mailing Address - Street 2:BARKLEY BLDG. STE 200
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243
Mailing Address - Country:US
Mailing Address - Phone:502-254-8880
Mailing Address - Fax:502-254-8870
Practice Address - Street 1:8701 OLD BARDSTOWN RD STE B
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-4435
Practice Address - Country:US
Practice Address - Phone:502-618-2823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical