Organization Active NPI

Your Psychological Needs, Inc.

  • Psychiatry Physician
  • Louisville, KY
National Provider Identifier
1023445913
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
YOUR PSYCHOLOGICAL NEEDS, INC.
Practice address
13113 Eastpoint Park Blvd Ste C
Louisville, KY 40223-4191
Phone
(502) 245-7258
Fax
(502) 489-5552
NPI assigned
Oct 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Donna L Clemens
Title
Credentialing Coordinator
Phone
(502) 489-4302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

13113 Eastpoint Park Blvd Ste C
Louisville, KY 40223-4191

Mailing address

13113 Eastpoint Park Blvd Ste C
Louisville, KY 40223-4191
Phone (502) 245-7258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140326000468 KY Part B Supplier - Clinic/Group Practice 8628209186 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1023445913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13113 EASTPOINT PARK BLVD STE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234191",
            "telephone_number": "502-245-7258",
            "fax_number": "502-489-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13113 EASTPOINT PARK BLVD STE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234191",
            "telephone_number": "502-245-7258",
            "fax_number": "502-489-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR PSYCHOLOGICAL NEEDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "502-489-4302",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.