Total Spectrum Autism Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

129006 Issued in KY

Legal business name

TOTAL SPECTRUM AUTISM SERVICES LLC

Practice address

515 Maplewood Blvd
Georgetown, IN 47122-9261

Phone

(502) 767-9405

Fax

(812) 727-5522

NPI assigned

Dec 15, 2016

Last updated

Dec 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Katerrell Leon Kennedy

Title

Ceo

Phone

(502) 767-9405

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 3

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.

• Luke Button

  • Behavior Technician
  • Georgetown, IN
  • NPI 1861936452
  NPD (past)
• Kaitlynn Jewell Decker, OTR

  • Occupational Therapist
  • Georgetown, IN
  • NPI 1568906154
  NPD (past)
• Michele L Delaney

  • Behavior Technician
  • Georgetown, IN
  • NPI 1043754633
  NPD (past)

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1932643590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MAPLEWOOD BLVD",
            "city": "GEORGETOWN",
            "state": "IN",
            "postal_code": "471229261",
            "telephone_number": "502-767-9405",
            "fax_number": "812-727-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MAPLEWOOD BLVD",
            "city": "GEORGETOWN",
            "state": "IN",
            "postal_code": "471229261",
            "telephone_number": "502-767-9405",
            "fax_number": "812-727-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL SPECTRUM AUTISM SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "KATERRELL",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-767-9405"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002390A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "129006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1235558628",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1013002443",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1790917060",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Thomas Steinwedel, DDS
• Kayla R Stinson, NP-C
• Bill Steve Tchachito Tema, RPH
• The Drug Store Inc
• Rebecca Todd, PT, DPT
• Tanesha Washington
• Richard Dana Weaver Jr., CSW, LSW
• Gretchen Weiser, P.T.
• Women's Healthcare of Southern Indiana LLC
• Bobbi Yates

• Clinical Psychologist in Georgetown, IN
• Providers in Georgetown, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.