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General NPI Number Information
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NPI Number | 1881873313
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Entity Type | Organization
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Legal Business Name | BICKETT AND ASSOCIATES
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 101 MANOR AVE SUITE 100
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City | BARDSTOWN
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State | KY
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Zip | 40004-2298
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Country | US
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Telephone | 502-349-1300
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Fax | 502-350-1177
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Provider Business Mailing Address
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Address Line | 101 MANOR AVE SUITE 100
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City | BARDSTOWN
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State | KY
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Zip | 40004-2298
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Country | US
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Telephone | 502-349-1300
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Fax | 502-350-1177
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ROBERT NEWMAN BICKETT
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Credential | PSY. D.
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Telephone | 502-349-1300
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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 | 1284
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License Number State | KY
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