Clinton M Nowicke, PSYCHOLOGY ASSISTANT

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

277977 Issued in KY

Practice address

3840 Ruckriegel Pkwy Ste 105
Louisville, KY 40299-6836

Phone

(502) 261-7227

NPI assigned

Aug 13, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cnowicke285688@direct.nortonhealthcare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Norton Children'S Medical Group, LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096

  Psychologist

  Medicare reassignment NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD
• Norton Childrens Medical Group, LLC

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255

  Psychologist

  NPD

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1831745223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-559-9425",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 RUCKRIEGEL PKWY STE 105",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402996836",
            "telephone_number": "502-261-7227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3086 State Route 160",
            "address_purpose": "LOCATION",
            "city": "Gallipolis",
            "state": "OH",
            "postal_code": "456318409",
            "country_code": "US",
            "telephone_number": "740-446-5500",
            "fax_number": "740-446-4951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWICKE",
        "first_name": "CLINTON",
        "middle_name": "M",
        "credential": "PSYCHOLOGY ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-13",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "277977",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Novotny, O.D.
• Now Works LLC
• Michael Nowacki, M.D.
• Bryce Nowak, PHARMD
• Lily Nowakowski
• Elizabeth E Nowlin, LCSW
• Shannon Noyer
• NP Services of Ky LLC
• Nput LLC
• Nucare Concierge, Inc

• 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 Feb 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.