Active NPI
Alexandria Pruitt, PSY.D.
- Clinical Psychologist
- Louisville, KY
National Provider Identifier
1710355722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 170916
- Practice address
- 912 Lily Creek Rd
Suite 201
Louisville, KY 40243 - Phone
- (502) 429-5431
- NPI assigned
- Sep 8, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 170916 | KY | Primary |
Addresses
Primary practice location
912 Lily Creek Rd
Suite 201
Louisville, KY 40243
Mailing address
912 Lily Creek Rd Ste 201
Louisville, KY 40243-2815
Phone (502) 338-0608
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
| License | State | Type | Specialty |
|---|---|---|---|
| 170916 | KY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537920000000",
"number": "1710355722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 LILY CREEK RD STE 201",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402432815",
"telephone_number": "502-338-0608",
"fax_number": "502-246-1888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 LILY CREEK RD",
"address_2": "SUITE 201",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40243",
"telephone_number": "502-429-5431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUITT",
"first_name": "ALEXANDRIA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-08",
"last_updated": "2018-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KY",
"license": "170916",
"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 Sep 26, 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.