Provider Demographics
NPI:1104232396
Name:TROST, LYUDMILA (MS)
Entity type:Individual
Prefix:
First Name:LYUDMILA
Middle Name:
Last Name:TROST
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 E BROADWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1037
Mailing Address - Country:US
Mailing Address - Phone:502-589-5731
Mailing Address - Fax:502-587-9355
Practice Address - Street 1:914 E BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1037
Practice Address - Country:US
Practice Address - Phone:502-589-5731
Practice Address - Fax:502-587-9355
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2014-62103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist