Basic Information
| Provider Information | |||||||||
| NPI: | 1013065523 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOJCIK | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.MIN, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3430 NEWBURG RD | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402182497 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5024548800 | ||||||||
| FaxNumber: | 5027360140 | ||||||||
| Practice Location | |||||||||
| Address1: | 3430 NEWBURG RD | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402182497 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5024548800 | ||||||||
| FaxNumber: | 5027360140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 0056 | KY | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.