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NPI Code Detail

MEDICARE: PERINATAL PRINCESS GROUP THERAPY

MEDICARE: PERINATAL PRINCESS GROUP THERAPY
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
1106H00000XMarriage & Family Therapist
2101YM0800XMental Health Counselor
3101YP2500XProfessional Counselor
41041C0700XClinical Social Worker

General Provider Information

NPI Number : 1437018967
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERINATAL PRINCESS GROUP THERAPY
Provider Business Mailing Address
First Line : 1949 GOLDSMITH LN STE 103
Second Line :
City : LOUISVILLE
State : KY
Zip : 40218-3096
Country : US
Telephone Number : 502-208-9294
Fax Number :
Provider Business Practice Location Address
First Line : 1949 GOLDSMITH LN STE 103
Second Line :
City : LOUISVILLE
State : KY
Zip : 40218-3096
Country : US
Telephone Number : 502-208-9294
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SHEMIKA WHITESIDE
Credential :
Telephone Number : 502-338-3624
Provider Enumeration Date : 01/20/2026
Last Update Date : 06/02/2026

Similar Medicare Providers

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40218-3096
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Directions to “PERINATAL PRINCESS GROUP THERAPY ” Practice Location

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