Boaz, Delora K.
Boaz, Delora K. is an sole proprietor health care provider with primary practice located at 708 Magazine St Ste 100 , Louisville KY 40203-3779. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Boaz, Delora K. can be contacted via phone (502) 589-8926.Contact Information
Primary practice address
708 Magazine St Ste 100
Louisville KY 40203-3779
Phone: (502) 589-8926
Fax: (502) 585-4218
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1369 | Kentucky |
| 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, LCADC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 23rd, 2005 |
| Last updated | Sep 2nd, 2026 - about last month |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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