Western Kentucky Behavioral Health

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Dixon, KY

NPI 1194156596 · NPPES record last updated Aug 18, 2023

Key facts

NPI
1194156596
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
WESTERN KENTUCKY BEHAVIORAL HEALTH
Practice address
2363 Lyce Duncan Rd
Dixon, KY 42409-9761
Phone
(270) 213-3635
Fax
(270) 213-5015
NPI assigned
Dec 10, 2013
Organization subpart
No

Authorized official

Name
Regina Elise Robison, APRN
Title
Owner
Phone
(270) 213-3635

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in KY, IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140303001707 KY Part B Supplier - Clinic/Group Practice 0749410280 Receives reassigned benefits from 1 practitioner
Practice locations: Dixon, KY
O20230808003807 IN Part B Supplier - Clinic/Group Practice 0749410280 Practice locations: Boonville, IN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

2363 Lyce Duncan Rd
Dixon, KY 42409-9761

Mailing address

2363 Lyce Duncan Rd
Dixon, KY 42409-9761
Phone (270) 213-0094

Other providers in Dixon, KY

All providers in Dixon, KY · Psychiatric/Mental Health Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.