Individual provider Active NPI

Kathryn Lynn Haendiges, PSY.D.

  • Psychologist
  • Louisville, KY
National Provider Identifier
1992109862
Registry record updated Aug 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSYLIP00210710 Issued in KY
Practice address
1941 Bishop LN Ste 711
Louisville, KY 40218-1937
Phone
(502) 377-4758
NPI assigned
Oct 21, 2014
Last updated
Aug 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1240 NH
Psychologist 103T00000X 016297-1 NY
Psychologist 103T00000X PSYLIP00210710 KY Primary

Addresses

Primary practice location

1941 Bishop LN Ste 711
Louisville, KY 40218-1937

Mailing address

1856 Alfresco PL
Louisville, KY 40205-1860
Phone (502) 377-4758

Other practice location 1

2212 Portland Ave
Louisville, KY 40212-1034
Phone (502) 774-8631

Other identifiers 1

IdentifierTypeStateIssuer
7100355800MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151208001061 KY Practitioner - Clinical Psychologist 0749580108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1941 Bishop LN
Suite 711
Louisville, KY 40218-1937
Phone (502) 377-4758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSYLIP00210710KYMDPsychologist
1240NHMDPsychologist
016297-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy B. Greenamyer, PHD, PLLC CurrentSince Oct 5, 2016 Accepting new patients
Kathryn Haendiges PSYD CurrentSince Dec 16, 2019 Accepting new patients

Locations

1941 Bishop Ln
Ste 711
Louisville, KY 40218
Phone (502) 377-4758

7984 New La Grange Rd
Louisville, KY 40222
Phone (502) 426-2777

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566086400000",
    "number": "1992109862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 ALFRESCO PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051860",
            "telephone_number": "502-377-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 BISHOP LN STE 711",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181937",
            "telephone_number": "502-377-4758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2212 PORTLAND AVE",
            "address_purpose": "LOCATION",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121034",
            "country_code": "US",
            "telephone_number": "502-774-8631",
            "fax_number": "502-772-8189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAENDIGES",
        "first_name": "KATHRYN",
        "middle_name": "LYNN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2019-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NH",
            "license": "1240",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "016297-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "PSYLIP00210710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100355800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.