Active NPI
Rafael Veroslavsky
- Clinical Psychologist
- Louisville, KY
National Provider Identifier
1245657766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2013-98
- Practice address
- 421 Benjamin LN Ste 202
Louisville, KY 40222-4845 - Phone
- (502) 690-8024
- NPI assigned
- Mar 21, 2014
- Last updated
- Feb 14, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2013-98 | KY | Primary |
Addresses
Primary practice location
421 Benjamin LN Ste 202
Louisville, KY 40222-4845
Mailing address
PO Box 2257
Chesterton, IN 46304-0357
Phone (219) 926-8320
Other practice location 1
107 Fenley Ave
J5
Louisville, KY 40207-2502
Phone (732) 841-6806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013-98 | KY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518566400000",
"number": "1245657766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2257",
"city": "CHESTERTON",
"state": "IN",
"postal_code": "463040357",
"telephone_number": "219-926-8320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 BENJAMIN LN STE 202",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402224845",
"telephone_number": "502-690-8024"
}
],
"practiceLocations": [
{
"address_1": "107 Fenley Ave",
"address_2": "J5",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402072502",
"country_code": "US",
"telephone_number": "732-841-6806",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VEROSLAVSKY",
"first_name": "RAFAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-21",
"last_updated": "2018-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KY",
"license": "2013-98",
"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 Feb 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.