| Psychology Resource Group, Pllc | |
|
7400 New Lagrange Rd Suite 301 Louisville KY 40222-4870 | |
| (502) 394-9990 | |
| Not Available |
| Full Name | Psychology Resource Group, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7400 New Lagrange Rd, Louisville, Kentucky |
| Authorized Official Name and Position | Robert Scott Watson (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 5025993172 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychology Resource Group, Pllc 7400 New Lagrange Rd Suite 301 Louisville KY 40222-4870 Ph: (502) 394-9990 | Psychology Resource Group, Pllc 7400 New Lagrange Rd Suite 301 Louisville KY 40222-4870 Ph: (502) 394-9990 |
| NPI Number | 1588445910 |
|---|---|
| Provider Enumeration Date | 10/11/2023 |
| Last Update Date | 10/11/2023 |
| Certification Date | 10/10/2023 |
| Medicare PECOS PAC ID | 7113378860 |
|---|---|
| Medicare Enrollment ID | O20240108003757 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588445910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Carol B Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629056080 PECOS PAC ID: 5395877617 Enrollment ID: I20100721000637 |
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