Psychologist, Clinical
MANDALA HOUSE, LLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1659829760 · enumerated 2016-09-18 · record updated 2026-06-05. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Dr. JACKS GILLES Psy.D., LP, Executive Director · (502) 309-2403
Other names: MANDALA HOUSE
Addresses and phones
- Mailing address 1169 EASTERN PKWY STE 3353, LOUISVILLE, KY, 40217-1415 (502) 309-2403 Fax (502) 771-4283 Google Maps Apple Maps OpenStreetMap
- Practice location 633 BAXTER AVE, LOUISVILLE, KY, 40204-1157 (502) 309-2408 Fax (502) 771-4283 Google Maps Apple Maps OpenStreetMap
Specialties
- Social Worker, Clinical 1041C0700X
- Psychologist, Counseling 103TC1900X
- Marriage & Family Therapist 106H00000X
- Psychologist 103T00000X
- Psychiatry & Neurology, Psychiatry 2084P0800X
- Psychologist, Clinical 103TC0700X · Primary
In this directory
Locations and evidence
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Practice location
LOUISVILLE, KY, 402041157
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.