Chestnut Park Professionals, LLC
Organization Active NPI Psychologist · Bowling Green, KY
NPI 1265574396 · NPPES record last updated Apr 12, 2012
Key facts
- NPI
- 1265574396
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- License
- 0670 (KY)
- Legal business name
- CHESTNUT PARK PROFESSIONALS, LLC
- Practice address
- 1215 High St
Bowling Green, KY 42101-2541 - Phone
- (270) 782-1116
- Fax
- (270) 782-9108
- NPI assigned
- Feb 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Corrie J Vos, PH.D.
- Title
- Owner
- Phone
- (270) 782-1116
Practitioners 27
-
Jill K Duncan, L.C.S.W.
-
Megan Rorex, LCSW
-
Frederick Glenn Grieve, PH.D.
-
Emilee Bevil, LPCC
-
Rockford Lee Cook, MA, LPCC
-
Aryn Elizabeth Meyer, LPCC
-
Phillip T Noffsinger, LPCC
-
Corrie J. Vos, PH.D.
-
John W Balchunas, PA
-
Amy Brausch, PH.D.
-
Rayscott Doyel, MA
-
Lela S. Dunn, PHD
-
Robert Bruce Fane, ED.D
-
Cheryl Osten Grieve, M.S., S.P.E., L.P.A.
-
Leeann Marie Horton, LPCC
-
Jennifer Johnson, LCSW
-
Virginia Lowery, MA
-
Brett Edward Scofield, PH.D.
-
Amanda J Wade, M.A.
-
Charles Webb, PSY.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051026000749 | KY | Part B Supplier - Clinic/Group Practice | 8921025230 |
Receives reassigned benefits from 6 practitioners Practice locations: Bowling Green, KY |
National Provider Directory
Locations
996 Wilkinson Trce
Ste A9
Bowling Green, KY 42103
Phone (270) 782-1116
1215 High St
Bowling Green, KY 42101
Phone (270) 782-1116
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | 0670 | KY | Yes |
Addresses
Primary practice location
1215 High St
Bowling Green, KY 42101-2541
Mailing address
1215 High St
Bowling Green, KY 42101-2541
Phone (270) 782-1116
Other providers in Bowling Green, KY
- Amy Lynn Cherry
- Lauren Cherry
- Rachel Cherry
- Tiffani Michelle Cherry
- William Kelley Cherry
- Sandeep Chhabra
- Heather G Childress
- Shannon Childress
- Anne Chimera
- Rutuja Chinchankar
All providers in Bowling Green, KY · Psychologist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.