Mary Southgate Clay Edinger

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

293649 Issued in KY

Practice address

130 Fairfax Ave Lowr Levelc
Louisville, KY 40207-4939

Phone

(502) 593-2618

NPI assigned

Sep 17, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alta Vista Counseling LLC

  • Marriage & Family Therapist
  • Louisville, KY
  • NPI 1013744747
  NPD Authorized official

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1063249704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 UPLAND RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062836",
            "telephone_number": "502-593-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FAIRFAX AVE LOWR LEVELC",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074939",
            "telephone_number": "502-593-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDINGER",
        "first_name": "MARY",
        "middle_name": "SOUTHGATE CLAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "293649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Claudette Eder
• Marion Jackson Edge, DMD
• Amy Carolyn Edgerton
• Lisa Renee Edgerton, RPH
• Edina Torlak MD, PSC
• Edith & Henry Heuser Hearing Institute
• Edith & Henry Heuser Hearing Institute
• Edith & Henry Heuser Hearing Institute
• Edith & Henry Heuser Hearing Institute
• Christina Edlin

• Marriage & Family Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Marriage & Family Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.