Individual provider Active NPI

Dawn Renee Wheatley-Hodge, MFT ASSOCIATE

  • Marriage & Family Therapist
  • Louisville, KY
National Provider Identifier
1609632181
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
289767 Issued in KY
Practice address
4420 Dixie Hwy Ste 230
Louisville, KY 40216-2986
Phone
(502) 432-2234
NPI assigned
Feb 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 289767 KY Primary

Addresses

Primary practice location

4420 Dixie Hwy Ste 230
Louisville, KY 40216-2986

Mailing address

10307 Beau Brummell Dr
Fairdale, KY 40118-9417
Phone (502) 432-2234

Other practice location 1

9310 Old Henry Rd
Louisville, KY 40245-6004
Phone (502) 432-2344

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
289767KYMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1609632181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10307 BEAU BRUMMELL DR",
            "city": "FAIRDALE",
            "state": "KY",
            "postal_code": "401189417",
            "telephone_number": "502-432-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 DIXIE HWY STE 230",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402162986",
            "telephone_number": "502-432-2234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9310 Old Henry Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402456004",
            "country_code": "US",
            "telephone_number": "502-432-2344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEATLEY-HODGE",
        "first_name": "DAWN",
        "middle_name": "RENEE",
        "credential": "MFT ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "289767",
            "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 Feb 22, 2024; 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.