Provider Demographics
NPI:1811651185
Name:KIMBRELL, LISA EHLSCHIDE (LPCA)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:EHLSCHIDE
Last Name:KIMBRELL
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8153 NEW LAGRANGE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-8613
Mailing Address - Country:US
Mailing Address - Phone:502-654-6964
Mailing Address - Fax:502-709-6005
Practice Address - Street 1:8153 NEW LAGRANGE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-8613
Practice Address - Country:US
Practice Address - Phone:502-654-6964
Practice Address - Fax:502-709-6005
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-23
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY288866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional