Stephanie Beaty

Individual provider Active NPI Speech-Language Pathologist · Mount Washington, KY

NPI 1962880401 · NPPES record last updated May 18, 2015

Key facts

NPI
1962880401
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
4003 (KY)
Practice address
1200 N Bardstown Rd
Mount Washington, KY 40047-7669
Phone
(502) 904-0300
NPI assigned
May 18, 2015
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
4003KYMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 4003 KY Yes

Addresses

Primary practice location

1200 N Bardstown Rd
Mount Washington, KY 40047-7669

Mailing address

2114 Starmont Rd
Louisville, KY 40207-1141

Other providers in Mount Washington, KY

All providers in Mount Washington, KY · Speech-Language Pathologist in Kentucky

Sources for this page

Verify at the official NPI Registry.