Shane Blume

Individual provider Active NPI Family Psychologist · Morehead, KY

NPI 1922581370 · NPPES record last updated Sep 12, 2018

Key facts

NPI
1922581370
Entity type
Individual (NPI type 1)
Primary specialty
Family Psychologist 103TF0000X
Practice address
316 E Main St
Morehead, KY 40351-1622
Phone
(606) 371-4002
NPI assigned
Sep 12, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Psychologist 103TF0000X Yes

Addresses

Primary practice location

316 E Main St
Morehead, KY 40351-1622

Mailing address

316 E Main St
Morehead, KY 40351-1622

Other providers in Morehead, KY

All providers in Morehead, KY · Family Psychologist in Kentucky

Sources for this page

Verify at the official NPI Registry.