NPIMap

Organization Active NPI

Whitten Psychological Services, PLLC.

  • Psychologist
  • Shelbyville, KY
National Provider Identifier
1871919977
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1677 Issued in KY
Legal business name
WHITTEN PSYCHOLOGICAL SERVICES, PLLC.
Practice address
1028 Main St
Shelbyville, KY 40065-1315
Phone
(502) 647-2477
Fax
(502) 371-0890
NPI assigned
Mar 13, 2014
Last updated
Oct 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Authorized official

Name
Esther Maeser
Title
Office Manager
Phone
(502) 647-2477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1677 KY Primary

Addresses

Primary practice location

1028 Main St
Shelbyville, KY 40065-1315

Mailing address

1028 Main St
Shelbyville, KY 40065-1315
Phone (502) 647-2477

Other practice location 1

10337 Linn Station Rd
Louisville, KY 40223-3816
Phone (502) 895-0000

Other identifiers 1

IdentifierTypeStateIssuer
7100333590MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140411001256 KY Part B Supplier - Clinic/Group Practice 7214169937 Receives reassigned benefits from 6 practitioners
Practice locations: Shelbyville, KY

National Provider Directory

National Provider Directory

Locations

519 Main St
Shelbyville, KY 40065
Phone (502) 647-2477

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1871919977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 MAIN ST",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651315",
            "telephone_number": "502-647-2477",
            "fax_number": "502-371-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 MAIN ST",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651315",
            "telephone_number": "502-647-2477",
            "fax_number": "502-371-0890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10337 Linn Station Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402233816",
            "country_code": "US",
            "telephone_number": "502-895-0000",
            "fax_number": "502-371-0890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHITTEN PSYCHOLOGICAL SERVICES, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-13",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "MAESER",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-647-2477"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "1677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100333590",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.