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NPI Code Detail

MEDICARE: WILLIAM SUMMAY

MEDICARE: WILLIAM SUMMAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor289905KY
2101YP2500XProfessional Counselor
3101YP2500XProfessional CounselorPC017814PPA

General Provider Information

NPI Number : 1093588725
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM SUMMAY
Provider Business Mailing Address
First Line : 633 BAXTER AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1157
Country : US
Telephone Number : 502-309-2408
Fax Number : 502-771-4283
Provider Business Practice Location Address
First Line : 633 BAXTER AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1157
Country : US
Telephone Number : 502-309-2408
Fax Number : 502-771-4283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2023
Last Update Date : 03/11/2026

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