| Psych, Inc | |
|
1015 S 4th St Louisville KY 40203-3207 | |
| (502) 272-9718 | |
| Not Available |
| Full Name | Psych, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1015 S 4th St, Louisville, Kentucky |
| Authorized Official Name and Position | Justin Anderson (PRESIDENT) |
| Authorized Official Contact | 5022729718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psych, Inc 1015 S 4th St Louisville KY 40203-3207 Ph: () - | Psych, Inc 1015 S 4th St Louisville KY 40203-3207 Ph: (502) 272-9718 |
| NPI Number | 1811324122 |
|---|---|
| Provider Enumeration Date | 10/01/2013 |
| Last Update Date | 06/29/2021 |
| Certification Date | 06/29/2021 |
| Medicare PECOS PAC ID | 7113152166 |
|---|---|
| Medicare Enrollment ID | O20131028001534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811324122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1732 (Kentucky) | Primary |
| 103TC0700X | Psychologist - Clinical | 1723 (Alabama) | Secondary |
| Provider Name | Justin Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780834390 PECOS PAC ID: 6709010861 Enrollment ID: I20131113001049 |
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