Healthcare Provider Details

I. General information

NPI: 1861823429
Provider Name (Legal Business Name): NATALIE PICKERING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 LEAWOOD DR STE C
FRANKFORT KY
40601-7776
US

IV. Provider business mailing address

1691 ZARING MILL RD
SHELBYVILLE KY
40065-9287
US

V. Phone/Fax

Practice location:
  • Phone: 502-352-2446
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1747
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: