Healthcare Provider Details

I. General information

NPI: 1245906643
Provider Name (Legal Business Name): KATHERINE PRICE PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATE PRICE

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CHESTNUT ST
LOUISVILLE KY
40202-1831
US

IV. Provider business mailing address

PO BOX 776879
CHICAGO IL
60677-6879
US

V. Phone/Fax

Practice location:
  • Phone: 502-588-0800
  • Fax:
Mailing address:
  • Phone: 502-559-9425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number286702
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: