NPIMap

Organization Active NPI

Eastpoint Psychological Services, PLLC

  • Psychologist
  • Louisville, KY
National Provider Identifier
1275842213
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
EASTPOINT PSYCHOLOGICAL SERVICES, PLLC
Practice address
13804 Lake Point Circle,
Suite 101
Louisville, KY 40223-4219
Phone
(502) 245-7258
Fax
(502) 245-7259
NPI assigned
Sep 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Dr. Jeffrey Lee Hicks, PHDNPI 1518143858
Title
Member
Phone
(502) 245-7258

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

13804 Lake Point Circle,
Suite 101
Louisville, KY 40223-4219

Mailing address

13804 Lake Point Circle,
Suite 101
Louisville, KY 40223-4219
Phone (502) 245-7258

National Provider Directory

National Provider Directory

Locations

13804 Lake Point Cir
Ste 101
Louisville, KY 40223
Phone (502) 245-7258

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1275842213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13804 LAKE POINT CIRCLE,",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234219",
            "telephone_number": "502-245-7258",
            "fax_number": "502-245-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13804 LAKE POINT CIRCLE,",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234219",
            "telephone_number": "502-245-7258",
            "fax_number": "502-245-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTPOINT PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-24",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "502-245-7258",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Dec 12, 2012; 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.