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General NPI Number Information
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NPI Number | 1457212359
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PSYCH CONSULTATION, LLC
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 137 CLASSIC CT
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City | VERSAILLES
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State | KY
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Zip | 40383-2069
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Country | US
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Telephone | 859-888-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 1603 CAPITOL AVE STE 299371
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City | CHEYENNE
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State | WY
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Zip | 82001-4569
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. ELIZABETH RUDISELL
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Credential | PSY.D.
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Telephone | 859-888-1335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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