Organization
PSYCH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN ANDERSON (PRESIDENT)
(502) 272-9718
Entity
Organization
Contact information
Practice address
1015 S 4TH ST, LOUISVILLE, KY 40203-3207
(502) 272-9718
Mailing address
1015 S 4TH ST, LOUISVILLE, KY 40203-3207
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1723
AL
103TC0700X
Clinical Psychologist
Primary
1732
KY
Other
Enumeration date
10/01/2013
Last updated
06/29/2021
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