Provider Demographics
NPI:1902961352
Name:KEMP, DRUSILLA R (PH D, LCSW)
Entity Type:Individual
Prefix:DR
First Name:DRUSILLA
Middle Name:R
Last Name:KEMP
Suffix:
Gender:F
Credentials:PH D, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 ROSEMARY DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-1118
Mailing Address - Country:US
Mailing Address - Phone:502-637-5270
Mailing Address - Fax:
Practice Address - Street 1:1711 BARDSTOWN RD # 206
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1256
Practice Address - Country:US
Practice Address - Phone:502-345-2820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical