Individual provider Active NPI

Colleen M Kirsch Hiltz White, LP

  • Psychologist
  • Glasgow, KY
National Provider Identifier
1609587070
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
282081 Issued in KY
Practice address
301 Professional Park Dr
Glasgow, KY 42141-3487
Phone
(270) 651-9696
Fax
(270) 651-0385
NPI assigned
Dec 7, 2022
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 282081 KY Primary

Addresses

Primary practice location

301 Professional Park Dr
Glasgow, KY 42141-3487

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other identifiers 2

IdentifierTypeStateIssuer
7100869080MedicaidKY
15813869OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230123000293 KY Practitioner - Clinical Psychologist 4880065259 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc CurrentSince Jan 15, 2023 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jan 15, 2023 Accepting new patients
Cumberland Family Medical Center Inc PastSince Jul 25, 2021 Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

89 C Michael Davenport Blvd
Ste 2
Frankfort, KY 40601
Phone (502) 875-0561

301 Professional Park Dr
Glasgow, KY 42141
Phone (270) 651-5004

311 W High St
Lebanon, KY 40033
Phone (270) 593-5811

350 Langdon St
Somerset, KY 42503
Phone (606) 678-8155

360 Amsden Ave
Ste 200
Versailles, KY 40383
Phone (270) 864-1472

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1609587070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROFESSIONAL PARK DR",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413487",
            "telephone_number": "270-651-9696",
            "fax_number": "270-651-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCH HILTZ WHITE",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-07",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "282081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100869080",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15813869",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.