Provider Demographics
NPI:1548712045
Name:LAURA B DREW LCSW LLC
Entity type:Organization
Organization Name:LAURA B DREW LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:B
Authorized Official - Last Name:DREW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-451-6887
Mailing Address - Street 1:2950 BRECKENRIDGE LN
Mailing Address - Street 2:SUITE 10A
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1462
Mailing Address - Country:US
Mailing Address - Phone:502-451-6887
Mailing Address - Fax:
Practice Address - Street 1:2950 BRECKENRIDGE LN
Practice Address - Street 2:SUITE 10A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1462
Practice Address - Country:US
Practice Address - Phone:502-451-6887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCSW0247Medicare UPIN