| Ppl Therapeutic Services Pllc | |
|
8206 Highview Ct Crestwood KY 40014-8105 | |
| (502) 262-2887 | |
| (502) 243-9517 |
| Full Name | Ppl Therapeutic Services Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 8206 Highview Ct, Crestwood, Kentucky |
| Authorized Official Name and Position | Jeffrey Hicks (OWNER) |
| Authorized Official Contact | 5022622887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppl Therapeutic Services Pllc 8206 Highview Ct Crestwood KY 40014-8105 Ph: (502) 262-2887 | Ppl Therapeutic Services Pllc 8206 Highview Ct Crestwood KY 40014-8105 Ph: (502) 262-2887 |
| NPI Number | 1104323252 |
|---|---|
| Provider Enumeration Date | 04/06/2018 |
| Last Update Date | 07/22/2024 |
| Certification Date | 07/22/2024 |
| Medicare PECOS PAC ID | 8527323989 |
|---|---|
| Medicare Enrollment ID | O20180606000408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104323252 | NPI | - | NPPES |
| 7100531350 | Medicaid | KY | |
| 7100536860 | Medicaid | KY | |
| 7100530170 | Medicaid | KY | |
| 7100589000 | Medicaid | KY |
| Provider Name | Shannon M Gambill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770913436 PECOS PAC ID: 3173574258 Enrollment ID: I20050207000177 |
| Provider Name | Allison Gayle Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760469134 PECOS PAC ID: 6709823347 Enrollment ID: I20050414000601 |
| Provider Name | Michael L Wardford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780702910 PECOS PAC ID: 7315967262 Enrollment ID: I20051207000030 |
| Provider Name | Mary H Simms-boone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801802954 PECOS PAC ID: 6608974928 Enrollment ID: I20070611000613 |
| Provider Name | Gregory D Perri |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265544415 PECOS PAC ID: 7113026204 Enrollment ID: I20070702000299 |
| Provider Name | Vickie L Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376630384 PECOS PAC ID: 2264533017 Enrollment ID: I20070723000721 |
| Provider Name | Wanda F France |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972701712 PECOS PAC ID: 7911083217 Enrollment ID: I20080327000155 |
| Provider Name | Carla L Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790941532 PECOS PAC ID: 9436218708 Enrollment ID: I20081103000014 |
| Provider Name | Carrie M Schultz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710095179 PECOS PAC ID: 1951449750 Enrollment ID: I20091117000001 |
| Provider Name | Cynthia Gawarecki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447260377 PECOS PAC ID: 0244410827 Enrollment ID: I20110215000218 |
| Provider Name | Polly V Raleigh-fields |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376589010 PECOS PAC ID: 0345422762 Enrollment ID: I20110307000627 |
| Provider Name | Charlene Cochran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881960953 PECOS PAC ID: 6406017300 Enrollment ID: I20120420000316 |
| Provider Name | Stacy L Mccune |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093858722 PECOS PAC ID: 2365692407 Enrollment ID: I20121025000302 |
| Provider Name | David Stephens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427169168 PECOS PAC ID: 5395988398 Enrollment ID: I20130823000233 |
| Provider Name | Natalie Gilpin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477992543 PECOS PAC ID: 9638304256 Enrollment ID: I20131106000883 |
| Provider Name | Sandra Teresa Mahoney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528327038 PECOS PAC ID: 7719209907 Enrollment ID: I20141124002441 |
| Provider Name | Carol A Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538561618 PECOS PAC ID: 9436473519 Enrollment ID: I20150120001679 |
| Provider Name | Jennifer Lee-woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912256967 PECOS PAC ID: 0143549857 Enrollment ID: I20150430002411 |
| Provider Name | Jeffrey L Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518143858 PECOS PAC ID: 3375622012 Enrollment ID: I20150609002520 |
| Provider Name | Jerri L Molina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295119915 PECOS PAC ID: 1052629623 Enrollment ID: I20150930002807 |
| Provider Name | Heather L Drawe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033552948 PECOS PAC ID: 9931400447 Enrollment ID: I20151228002077 |
| Provider Name | Beth Deyoung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104275031 PECOS PAC ID: 5294023958 Enrollment ID: I20161012001283 |
| Provider Name | Michelle M Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780027532 PECOS PAC ID: 6507145786 Enrollment ID: I20161110001014 |
| Provider Name | Tiffanie D Conley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225403207 PECOS PAC ID: 0143509893 Enrollment ID: I20161121000601 |
| Provider Name | Jennifer Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174063234 PECOS PAC ID: 1355627134 Enrollment ID: I20170410001338 |
| Provider Name | Miranda Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487177242 PECOS PAC ID: 5597037960 Enrollment ID: I20170818002492 |
| Provider Name | Jennifer Yost Vaden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356876940 PECOS PAC ID: 9931471273 Enrollment ID: I20170821002250 |
| Provider Name | Catherine L Stone Hahn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962892125 PECOS PAC ID: 7012277338 Enrollment ID: I20180207000254 |
| Provider Name | Amy L Feusner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306347844 PECOS PAC ID: 2567726284 Enrollment ID: I20180504001903 |
| Provider Name | Andrea Denise Wickersham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942705652 PECOS PAC ID: 9133484132 Enrollment ID: I20180522001758 |
| Provider Name | Jo Ann Elbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508359134 PECOS PAC ID: 0749539229 Enrollment ID: I20180816000567 |
| Provider Name | Aaron Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780099481 PECOS PAC ID: 9739426438 Enrollment ID: I20190201002057 |
| Provider Name | William Anthony Mathis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639408990 PECOS PAC ID: 9234568023 Enrollment ID: I20200330002560 |
| Provider Name | Stephanie Landes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972082170 PECOS PAC ID: 9133472574 Enrollment ID: I20200403002202 |
| Provider Name | Michelle M. Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639589062 PECOS PAC ID: 5597194084 Enrollment ID: I20200403003091 |
| Provider Name | Valorie D Marlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801348719 PECOS PAC ID: 2466733696 Enrollment ID: I20200504000564 |
| Provider Name | Sarah Pierson Kerrick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033587894 PECOS PAC ID: 0840612347 Enrollment ID: I20200629002303 |
| Provider Name | Christa K Butcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972115699 PECOS PAC ID: 4385064351 Enrollment ID: I20201013002065 |
| Provider Name | Megan Lindsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851532501 PECOS PAC ID: 5496805376 Enrollment ID: I20201016002510 |
| Provider Name | Megan Neal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275082208 PECOS PAC ID: 0547680225 Enrollment ID: I20201019001772 |
| Provider Name | Tonia Skaggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932657749 PECOS PAC ID: 4880014570 Enrollment ID: I20201019002342 |
| Provider Name | Lisa R Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316545817 PECOS PAC ID: 7719307420 Enrollment ID: I20201019003157 |
| Provider Name | Tyler J Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467050856 PECOS PAC ID: 7719307347 Enrollment ID: I20201020000687 |
| Provider Name | Sandra L Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740888171 PECOS PAC ID: 1153741665 Enrollment ID: I20201022002395 |
| Provider Name | Thomas C Kurtz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912540105 PECOS PAC ID: 3072923267 Enrollment ID: I20201028002741 |
| Provider Name | Karen Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114528536 PECOS PAC ID: 0143630921 Enrollment ID: I20201105002638 |
| Provider Name | Kristin Windchy Law |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306446216 PECOS PAC ID: 7012328636 Enrollment ID: I20201202002215 |
| Provider Name | Whitney I Radford-mcgee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972968246 PECOS PAC ID: 4587076054 Enrollment ID: I20201208001118 |
| Provider Name | Terri L Valencia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023015161 PECOS PAC ID: 0446662712 Enrollment ID: I20201209002950 |
| Provider Name | Kelly Fallon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194119941 PECOS PAC ID: 8224441803 Enrollment ID: I20201229002070 |
| Provider Name | Kimberly Hayes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508316258 PECOS PAC ID: 1052724259 Enrollment ID: I20210107001635 |
| Provider Name | Jessica Hyden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518552561 PECOS PAC ID: 7618386723 Enrollment ID: I20210430001791 |
| Provider Name | Steven W Triplett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629658141 PECOS PAC ID: 0042629099 Enrollment ID: I20210504002464 |
| Provider Name | Janna D Cheek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164198966 PECOS PAC ID: 6002211174 Enrollment ID: I20210827001073 |
| Provider Name | Gregory Lucas Mcfall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861168676 PECOS PAC ID: 9537566310 Enrollment ID: I20210921002193 |
| Provider Name | Melissa Mcintosh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821543786 PECOS PAC ID: 8325445125 Enrollment ID: I20210921003113 |
| Provider Name | Elisha L Hussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417612672 PECOS PAC ID: 8123412368 Enrollment ID: I20220303001670 |
| Provider Name | Sidney Sebastian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790452894 PECOS PAC ID: 4587051982 Enrollment ID: I20220504001504 |
| Provider Name | Ashley Elizabeth Reid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255888749 PECOS PAC ID: 2668859398 Enrollment ID: I20220518000384 |
| Provider Name | Tomius R Neal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134737992 PECOS PAC ID: 3173901154 Enrollment ID: I20220602002720 |
| Provider Name | Aleesha Cape Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982347746 PECOS PAC ID: 4587044565 Enrollment ID: I20220707004074 |
| Provider Name | Ashley B Langford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982331443 PECOS PAC ID: 1254714348 Enrollment ID: I20220823002313 |
| Provider Name | Justin T Carsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013645639 PECOS PAC ID: 4981080694 Enrollment ID: I20221004002172 |
| Provider Name | Kristian Renee Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023773132 PECOS PAC ID: 7113303645 Enrollment ID: I20221006000279 |
| Provider Name | Margaret Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164146890 PECOS PAC ID: 6103292255 Enrollment ID: I20221014002059 |
| Provider Name | Jerry Wayne Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720718620 PECOS PAC ID: 2365818804 Enrollment ID: I20221025000381 |
| Provider Name | Gabrielle Kiedren Louise Holden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811613995 PECOS PAC ID: 9537538525 Enrollment ID: I20221214001256 |
| Provider Name | Lauren Barks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033820774 PECOS PAC ID: 4385016500 Enrollment ID: I20230215002357 |
| Provider Name | Shannon D Fyffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821704628 PECOS PAC ID: 4981077898 Enrollment ID: I20230223001780 |
| Provider Name | Miranda J Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215633862 PECOS PAC ID: 9931572856 Enrollment ID: I20230223002016 |
| Provider Name | Mary Allison Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154024495 PECOS PAC ID: 3870968035 Enrollment ID: I20230331001934 |
| Provider Name | Shelley Maria Ison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255950523 PECOS PAC ID: 5890153589 Enrollment ID: I20230628002101 |
| Provider Name | Linda L Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881379006 PECOS PAC ID: 8921469412 Enrollment ID: I20230731003728 |
| Provider Name | Christine E Nicolosi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689807406 PECOS PAC ID: 4486016102 Enrollment ID: I20230811003275 |
| Provider Name | Angel E Opara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710669072 PECOS PAC ID: 0941663934 Enrollment ID: I20230823003249 |
| Provider Name | Christina Marie Pellman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003490442 PECOS PAC ID: 5991168775 Enrollment ID: I20230825003035 |
| Provider Name | Anna A Schoeneman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891475414 PECOS PAC ID: 8325401060 Enrollment ID: I20230829002867 |
| Provider Name | Ofonime John Ekpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790475739 PECOS PAC ID: 9830552058 Enrollment ID: I20230905003567 |
| Provider Name | Elisabeth B Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467145367 PECOS PAC ID: 3274997242 Enrollment ID: I20230908001889 |
| Provider Name | Cara L Whalen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215647672 PECOS PAC ID: 1254793326 Enrollment ID: I20230918002654 |
| Provider Name | Magdalen K Mekoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972387991 PECOS PAC ID: 2264886571 Enrollment ID: I20230920002025 |
| Provider Name | Camille Brooke Robidoux |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255686689 PECOS PAC ID: 4688022502 Enrollment ID: I20231201002562 |
| Provider Name | Jayme Lee Linville-begley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871189431 PECOS PAC ID: 6305296013 Enrollment ID: I20231221000712 |
| Provider Name | Meaghan Elizabeth White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295209930 PECOS PAC ID: 6406209337 Enrollment ID: I20240126003889 |
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