# VANDIVIER AND ASSOCIATES PSC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1861583361
- **Authorized official:** DAN K. VANDIVIER PHD (OWNER)
- **Authorized official phone:** (502) 458-7366

## Contact information

- **Practice address:** 903 BAXTER AVE, LOUISVILLE, KY 40204-2046
- **Practice address phone:** (502) 458-7366
- **Practice address fax:** (502) 458-7362
- **Mailing address:** 903 BAXTER AVE, LOUISVILLE, KY 40204-2046
- **Mailing address phone:** (502) 458-7366
- **Mailing address fax:** (502) 458-7362

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000060157 | ANTHEM BCBS | — |