# EASTPOINT PSYCHOLOGICAL SERVICES, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275842213
- **Authorized official:** DR. JEFFREY LEE HICKS PHD (MEMBER)
- **Authorized official phone:** (502) 245-7258

## Contact information

- **Practice address:** 13804 LAKE POINT CIRCLE,, SUITE 101, LOUISVILLE, KY 40223-4219
- **Practice address phone:** (502) 245-7258
- **Practice address fax:** (502) 245-7259
- **Mailing address:** 13804 LAKE POINT CIRCLE,, SUITE 101, LOUISVILLE, KY 40223-4219
- **Mailing address phone:** (502) 245-7258
- **Mailing address fax:** (502) 245-7259

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 09/24/2010
- **Last updated:** 12/12/2012