Justin O'Neal Anderson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1723 Issued in AL

Practice address

1015 S 4TH St
Louisville, KY 40203-3207

Phone

(502) 272-9718

NPI assigned

Sep 19, 2008

Last updated

Jun 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Psych, Inc Other name

Medicare fee-for-service enrollment

Enrolled in KY, AL2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Psych, Inc

  • Clinical Psychologist
  • Louisville, KY
  • NPI 1811324122

  AL

  Medicare reassignment Authorized official
• Smith & Associates Counseling PLLC

  dba Smith & Associates Psychotherapy Services

  • Community/Behavioral Health Agency
  • Louisville, KY
  • NPI 1982451944
  NPD
• Whitten Psychological Services, PLLC.

  • Psychologist
  • Shelbyville, KY
  • NPI 1871919977
  NPD (past)

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1780834390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033207",
            "telephone_number": "502-272-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033207",
            "telephone_number": "502-272-9718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JUSTIN",
        "middle_name": "O'NEAL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-19",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "1732",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1723",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "46-2967720",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PSYCH,",
            "last_name": "INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Anderson, PA
• John Alan Anderson, DDS
• Joseph Tyler Anderson, MD
• Joshua Anderson, DO
• Justin Douglas Anderson, MD
• Kara Lee Anderson, DNP, APRN, CPNP-PC
• Kenneth C Anderson, MD
• Kiran Anderson, M.D.
• Kristopher Anderson, CSW
• Latrice Anderson, R.N.

• Clinical Psychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.