Beasley, Ieisha

Beasley, Ieisha is an individual health care provider with primary practice located at 4420 Dixie Hwy Ste 126 , Louisville KY 40216-2994. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Beasley, Ieisha can be contacted via phone (502) 810-3780.

Contact Information

Primary practice address
4420 Dixie Hwy Ste 126 Louisville KY 40216-2994
Phone: (502) 810-3780
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 252275 Kentucky

Profile Details

NPI number 1760776322
LBN Legal business name Beasley, Ieisha
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2011
Last updated Feb 8th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760776322 NPPES
Kentucky MEDICAID 7100487470

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