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NPI Code Detail

MEDICARE: PEACE OF MIND PSYCHIATRY, PLLC

MEDICARE: PEACE OF MIND PSYCHIATRY, PLLC
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
1251S00000XCommunity/Behavioral Health Agency
2363L00000XNurse Practitioner
3363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1265205553
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEACE OF MIND PSYCHIATRY, PLLC
Provider Business Mailing Address
First Line : 110 S SHERRIN AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-3222
Country : US
Telephone Number : 502-548-9100
Fax Number :
Provider Business Practice Location Address
First Line : 110 S SHERRIN AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-3222
Country : US
Telephone Number : 502-548-9100
Fax Number :
Authorized Official
Title or Position : CREDENTIALING AGENT
Name : CARA NETHERTON
Credential :
Telephone Number : 859-248-6415
Provider Enumeration Date : 10/30/2023
Last Update Date : 08/11/2025

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Directions to “PEACE OF MIND PSYCHIATRY, PLLC ” Practice Location

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