Louisville Psychotherapy Group, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

LOUISVILLE PSYCHOTHERAPY GROUP, LLC

Practice address

1711 Bardstown Rd Ste 202
Louisville, KY 40205-2258

Phone

(502) 208-8794

NPI assigned

Dec 16, 2020

Organization subpart

No

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

Authorized official

Name

Eric Russ, PH.D.NPI 1912268731

Title

Owner

Phone

(404) 290-7916

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric U Russ, PH.D.

  • Clinical Psychologist
  • Louisville, KY
  • NPI 1912268731
  NPD Authorized official

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1770179517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 1/2 TALBOTT AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052271",
            "telephone_number": "404-290-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 BARDSTOWN RD STE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052258",
            "telephone_number": "502-208-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE PSYCHOTHERAPY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "RUSS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-290-7916",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Louisville, KY
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• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.