Provider Demographics
NPI:1235969817
Name:ODOM, MARGARET (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:
Last Name:ODOM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 FOXFIRE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2781
Mailing Address - Country:US
Mailing Address - Phone:502-472-1881
Mailing Address - Fax:
Practice Address - Street 1:9520 ORMSBY STATION RD STE 15
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5017
Practice Address - Country:US
Practice Address - Phone:502-472-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY105791106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist