Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mandala House, LLC

Organization Psychologist · NPI 1659829760

Mandala House, LLC is a Psychologist in Louisville, Kentucky. Works from 3 locations. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
6
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

633 Baxter Ave
Louisville, KY 40204-1157
Phone: (502) 309-2408
Fax: (502) 771-4283
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1190 E Broadway, Louisville, KY 40204-1712 — (502) 627-0905
  • 1169 Eastern Pkwy Ste 3353, Louisville, KY 40217-1415 — (502) 309-2408

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X
Psychologist Taxonomy 103T00000X
Counseling Psychologist Taxonomy 103TC1900X
Clinical Social Worker Taxonomy 1041C0700X
Marriage & Family Therapist Taxonomy 106H00000X
Psychiatry Physician Taxonomy 2084P0800X

Record details

NPI number1659829760
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacks Gilles — Executive Director · (502) 309-2403
Other names Mandala House; Mandala House
NPI enumeratedSeptember 18, 2016
Last updated in NPPESJune 5, 2026
Certification dateJune 5, 2026
Mailing address1169 Eastern Pkwy Ste 3353, Louisville, KY 40217-1415

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