Spectra Mental Healthcare, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SPECTRA MENTAL HEALTHCARE, PLLC

Practice address

214 Breckenridge LN
104
Louisville, KY 40207-3868

Phone

(502) 893-3388

NPI assigned

Jan 13, 2007

Last updated

May 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karl BatesNPI 1720139140

Title

Owner

Phone

(502) 893-3388

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Karl Bates

  • Clinical Social Worker
  • Louisville, KY
  • NPI 1720139140
  Authorized official Same address or phone

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1275684698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BRECKENRIDGE LN",
            "address_2": "104",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BRECKENRIDGE LN",
            "address_2": "104",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073868",
            "telephone_number": "502-893-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRA MENTAL HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-13",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-893-3388"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS & BLUE SHIELD",
            "identifier": "000000344330",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8290021800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.