| Mindive | |
|
119 S. Sherrin Ave Ste 240 Louisville KY 40207-3237 | |
| (502) 509-6002 | |
| (502) 415-7263 |
| Full Name | Mindive |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 119 S. Sherrin Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Chris Eric Davis (PARTNER/OWNER) |
| Authorized Official Contact | 5025096002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindive 119 S. Sherrin Ave Ste 240 Louisville KY 40207-3237 Ph: (502) 509-6002 | Mindive 119 S. Sherrin Ave Ste 240 Louisville KY 40207-3237 Ph: (502) 509-6002 |
| NPI Number | 1447973417 |
|---|---|
| Provider Enumeration Date | 09/23/2022 |
| Last Update Date | 01/27/2025 |
| Certification Date | 01/27/2025 |
| Medicare PECOS PAC ID | 9133649403 |
|---|---|
| Medicare Enrollment ID | O20250218001340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447973417 | NPI | - | NPPES |
| Provider Name | Zakary E Kendall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851721757 PECOS PAC ID: 6406209659 Enrollment ID: I20240124002735 |
| Provider Name | Christopher Davis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1508294430 PECOS PAC ID: 4183144454 Enrollment ID: I20250218001759 |
| Provider Name | Victoria A Serrano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720111933 PECOS PAC ID: 5395182471 Enrollment ID: I20250220003266 |
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