Individual provider Active NPI

Jacquelyn Love, PSY.D.

  • Clinical Psychologist
  • Louisville, KY
National Provider Identifier
1376823542
Registry record updated Dec 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042997A Issued in IN
Practice address
3526 Ephraim McDowell Dr
Louisville, KY 40205-3224
Phone
(260) 450-1417
NPI assigned
Aug 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 173460 KY
Clinical Psychologist 103TC0700X 20042997A IN Primary

Addresses

Primary practice location

3526 Ephraim McDowell Dr
Louisville, KY 40205-3224

Mailing address

175 Country Club Estates Dr SE
Corydon, IN 47112-1799
Phone (260) 450-1417

Other practice location 1

502 Hausfeldt Ln
New Albany, IN 47150-2221
Phone (260) 450-1417

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20042997AINMDClinical Psychologist
173460KYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545609600000",
    "number": "1376823542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 COUNTRY CLUB ESTATES DR SE",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471121799",
            "telephone_number": "260-450-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3526 EPHRAIM MCDOWELL DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053224",
            "telephone_number": "260-450-1417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Hausfeldt Ln",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471502221",
            "country_code": "US",
            "telephone_number": "260-450-1417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVE",
        "first_name": "JACQUELYN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2018-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "173460",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042997A",
            "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 Dec 24, 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.

Verify at the official NPI Registry.