Provider Demographics
NPI:1144935271
Name:THE PROMISED GENERATION
Entity type:Organization
Organization Name:THE PROMISED GENERATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AILEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRYANT-WALES
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, TCADC
Authorized Official - Phone:502-384-5807
Mailing Address - Street 1:9913 SHELBYVILLE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2902
Mailing Address - Country:US
Mailing Address - Phone:502-417-9799
Mailing Address - Fax:
Practice Address - Street 1:9913 SHELBYVILLE RD STE 103
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2902
Practice Address - Country:US
Practice Address - Phone:502-417-9799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty