# SPECIALISTSMAT PSC

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

## Provider details

- **NPI number:** 1851998181
- **Authorized official:** CARA NICOLE NETHERTON (PRACTICE MANAGER)
- **Authorized official phone:** (502) 212-0071

## Contact information

- **Practice address:** 110 CHASE WAY STE 2, ELIZABETHTOWN, KY 42701-7827
- **Practice address phone:** (502) 212-0071
- **Practice address fax:** (502) 530-5303
- **Mailing address:** 110 CHASE WAY STE 2, ELIZABETHTOWN, KY 42701-7827
- **Mailing address phone:** (502) 212-0071
- **Mailing address fax:** (502) 996-8359

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | — | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 10/09/2020
- **Last updated:** 11/17/2025