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NPI Code Detail

MEDICARE: LISA CHENEY PSY.D.

MEDICARE: LISA CHENEY PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC2200XClinical Child & Adolescent PsychologistNOT ASSIGNEDKY

General Provider Information

NPI Number : 1134397706
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA CHENEY PSY.D.
Provider Business Mailing Address
First Line : 915 MEMORIAL CT
Second Line :
City : ELIZABETHTOWN
State : KY
Zip : 42701-2525
Country : US
Telephone Number : 270-765-6709
Fax Number : 270-769-3779
Provider Business Practice Location Address
First Line : 915 MEMORIAL CT
Second Line :
City : ELIZABETHTOWN
State : KY
Zip : 42701-2525
Country : US
Telephone Number : 270-765-6709
Fax Number : 270-769-3779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2008
Last Update Date : 02/15/2008

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