Provider Demographics
NPI:1790224061
Name:THRESHOLD SERVICES, PLLC
Entity type:Organization
Organization Name:THRESHOLD SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:HEFFNER
Authorized Official - Last Name:RHEMA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:502-550-0576
Mailing Address - Street 1:212 W ORMSBY AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2820
Mailing Address - Country:US
Mailing Address - Phone:502-550-0576
Mailing Address - Fax:502-635-2457
Practice Address - Street 1:1347 S 3RD ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-3306
Practice Address - Country:US
Practice Address - Phone:502-550-0576
Practice Address - Fax:502-635-2457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-19
Last Update Date:2017-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100432760Medicaid