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General NPI Number Information
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NPI Number | 1417772013
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Entity Type | Organization
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Legal Business Name | GINA MAJESTRO, PSYD, LLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 4600 SHELBYVILLE RD STE 126
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City | LOUISVILLE
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State | KY
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Zip | 40207-3398
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Country | US
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Telephone | 502-762-4261
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Fax |
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Provider Business Mailing Address
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Address Line | 1169 EASTERN PKWY STE 3351
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City | LOUISVILLE
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State | KY
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Zip | 40217-1415
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Country | US
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Telephone | 502-762-4261
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Fax | 502-371-8124
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST, OWNER
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Name | REGINA MAJESTRO
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Credential | PSYD
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Telephone | 502-762-4261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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