Individual provider Active NPI

Stelios Jack Stylianou, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Louisville, KY
National Provider Identifier
1841530722
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
2012-107 Issued in KY
Practice address
548 Brentwood Ave
Louisville, KY 40215-2844
Phone
(502) 693-3437
NPI assigned
Feb 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 2012-107 KY Primary

Addresses

Primary practice location

548 Brentwood Ave
Louisville, KY 40215-2844

Mailing address

548 Brentwood Ave
Louisville, KY 40215-2844
Phone (502) 693-3437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828003444 KY Practitioner - Psychiatry 6608315106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aptiva HealthGroup PAC ID 0547595316, 36 clinicians

Practice addresses (Care Compare)

10100 Linn Station Rd
Suite 1a
Louisville, KY 40223-3861
Phone (502) 909-0772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2012-107KYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aptiva Health CurrentSince May 3, 2024 Accepting new patients
Aptiva Health CurrentSince May 3, 2024 Accepting new patients

Locations

529 Westport Rd
Ste 2
Elizabethtown, KY 42701

2093 Medical Arts Dr
Hebron, KY 41048
Phone (859) 442-6600

426 Codell Dr
Ste 100
Lexington, KY 40509

230 Fountain Ct
Ste 180
Lexington, KY 40509
Phone (859) 276-5008

12300 Plantside Dr
Louisville, KY 40299

401 N English Station Rd
Louisville, KY 40223

3615 Newburg Rd
Louisville, KY 40218
Phone (502) 583-1011

300 S 13th St
Louisville, KY 40203
Phone (502) 583-1011

10100 Linn Station Rd
Ste 1A
Louisville, KY 40223
Phone 5029090772 ext. 85585

3611 Newburg Rd
Louisville, KY 40218

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1841530722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 BRENTWOOD AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402152844",
            "telephone_number": "502-693-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 BRENTWOOD AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402152844",
            "telephone_number": "502-693-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STYLIANOU",
        "first_name": "STELIOS",
        "middle_name": "JACK",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "KY",
            "license": "2012-107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.