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Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Other names
Norton Children's Psychiatry and Psychology
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLEY GAST (SYST VP MNGD CARE & PAYOR STRAT)
(502) 272-5335
Entity
Organization
Contact information
Practice address
4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
(502) 272-5336
(502) 272-5339
Mailing address
PO BOX 766879, CHICAGO, IL 60677-6879
(502) 272-5336
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/07/2019
Last updated
09/22/2021
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