Provider Demographics
NPI:1588098925
Name:LOGSDON, EMILY (LPCA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:LOGSDON
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8151 NEW LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4685
Mailing Address - Country:US
Mailing Address - Phone:502-400-8099
Mailing Address - Fax:502-473-1070
Practice Address - Street 1:509 BARRET AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204
Practice Address - Country:US
Practice Address - Phone:502-485-0722
Practice Address - Fax:502-485-0792
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY242570101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health