Chad Stafford, P.A.
Individual provider Active NPI Psychologist · Frenchburg, KY
NPI 1023189016 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023189016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 0570 (KY)
- Practice address
- 70 Main Street
Frenchburg, KY 40322 - Phone
- (606) 768-2131
- Fax
- (606) 768-2134
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0570 | KY | Yes |
Addresses
Primary practice location
70 Main Street
Frenchburg, KY 40322
Mailing address
PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30610026 | Medicaid | KY |
Other providers in Frenchburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.