Boaz, Delora K.

Boaz, Delora K. is an individual health care provider with primary practice located at 600 S Preston St , Louisville KY 40202-1716. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Boaz, Delora K. can be contacted via phone (502) 583-3951.

Contact Information

Primary practice address
600 S Preston St Louisville KY 40202-1716
Phone: (502) 583-3951
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 1369 Kentucky
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0008 Kentucky

Profile Details

NPI number 1285637389
LBN Legal business name Boaz, Delora K.
Credentials LCSW, CADC
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Nov 13th, 2013 - about 13 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 1285637389 NPPES
Kentucky MEDICAID 65927857
Kentucky Other 50704000
Kentucky Other 701764000
Kentucky MEDICAID 82000902
Kentucky Other 2748490000
Kentucky Other 2748490000
Kentucky MEDICAID 82900176
Kentucky Other CK2274
Kentucky Other 000000056294
Kentucky MEDICAID 78903689
Kentucky Other 000000312667
Kentucky Other 6764

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