Provider Demographics
NPI:1124733415
Name:POPS HOUSE
Entity type:Organization
Organization Name:POPS HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC, LMFT, SAP
Authorized Official - Phone:502-409-4357
Mailing Address - Street 1:3934 DIXIE HWY STE 330
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-4170
Mailing Address - Country:US
Mailing Address - Phone:502-409-4357
Mailing Address - Fax:502-873-5048
Practice Address - Street 1:3934 DIXIE HWY STE 330
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-4170
Practice Address - Country:US
Practice Address - Phone:502-409-4357
Practice Address - Fax:502-873-5048
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHOICES COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-20
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty