Julie C Etzel, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1616 Issued in KY

Practice address

1169 Eastern Pkwy
Suite 3357
Louisville, KY 40217-1417

Phone

(502) 454-0755

Fax

(502) 479-1231

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1932293693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY",
            "address_2": "SUITE 2266",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171417",
            "telephone_number": "502-238-3178",
            "fax_number": "502-238-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY",
            "address_2": "SUITE 3357",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171417",
            "telephone_number": "502-454-0755",
            "fax_number": "502-479-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETZEL",
        "first_name": "JULIE",
        "middle_name": "C",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "1616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY PSYCHOLOGY LICENSE",
            "identifier": "1616",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE LIC",
            "identifier": "071-007127",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Wayne Etoch, MD
• Danielle Etter, LCSW
• Simone S Etter, DPT
• Joseph William Etterer
• Douglas S Ettin, MD
• Jennifer Rose Eubank, OTR/L, MS
• Eubanks & Marshall PSC
• Lindsay R Eubanks, M.ED., OTR/L, ATP
• Eudaimonia PLLC
• Eugene Giles Sr MD PSC (Omni Medical Center)

• 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 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.