Healthcare Provider Details

I. General information

NPI: 1205052461
Provider Name (Legal Business Name): RICHARD APPLEGATE M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 NEW GLENDALE RD
ELIZABETHTOWN KY
42701-8372
US

IV. Provider business mailing address

820 NEW GLENDALE RD
ELIZABETHTOWN KY
42701-8372
US

V. Phone/Fax

Practice location:
  • Phone: 270-766-5283
  • Fax: 270-766-5287
Mailing address:
  • Phone: 270-766-5283
  • Fax: 270-766-5287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0003
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0564
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: