Jennifer Anne Beasley
Individual provider Active NPI Art Therapist · La Grange, KY
NPI 1629450366 · NPPES record last updated Jun 14, 2016
Key facts
- NPI
- 1629450366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Art Therapist 221700000X
- License
- 114296 (KY)
- Practice address
- 2141 Spencer CT
La Grange, KY 40031-6742 - Phone
- (502) 222-7210
- NPI assigned
- Jun 18, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114296 | KY | MD | Art Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | 114296 | KY | Yes |
Addresses
Primary practice location
2141 Spencer CT
La Grange, KY 40031-6742
Mailing address
101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Phone (502) 589-8600
Other names
- Mrs. Jennifer Beasley Jost
Other providers in La Grange, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.