WISDOM KEY BEHAVIORAL HEALTH SERVICES INC (NPI# 1114263100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114263100 |
Entity Type | Organization |
Organization Name | WISDOM KEY BEHAVIORAL HEALTH SERVICES INC |
Practice Address |
1239 Woodland Dr Suite 110 Elizabethtown KY 42701-2770 |
Mailing Address |
56 Dawson Rd Radcliff KY 40160-9755 |
Practice Telephone | 2709000094 |
Practice Fax Number | 2709000430 |
Mailing Telephone | 2709000094 |
Mailing Fax Number | 2709000430 |
Enumeration Date | 2012-12-18 |
Last Update Date | 2014-02-28 |
Authorized Official Name | NANCY WILLIAMS (MANAGER) |
Authorized Official Telephone | 2709000094 |
Authorized Official Credential | PMHNP-BC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
3006237 | KY | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | MEDICARE PTAN | K085600 | 01 |
KY | PENDING | 05 |
Street Address |
1239 WOODLAND DR SUITE 110 |
City | ELIZABETHTOWN |
State | KY |
Zip Code | 42701-2770 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609858539 | Ijaz Mahmood | Internal Medicine | 1239 Woodland Dr, Suite 105, Elizabethtown, KY 42701-2770 | 2005-11-16 |
1457992570 | Marinda Moore Schneider | Nurse Practitioner | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-09-30 |
1780246785 | Jordan Harrison | Behavior Technician | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-07-01 |
1700346665 | Tiffani Romayne Wallace | Behavior Technician | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-03-25 |
1881162428 | Kristina Marie Boshart | Behavioral Analyst | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2018-11-12 |
1598233132 | Sandrea L Patterson | Behavior Technician | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2018-11-12 |
1164970448 | Heartland Whole Brain Learning-pediatric & Adult Therapy LLC | Developmental Therapist | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2016-09-15 |
1922443480 | Etown Family Practice Plc | Clinic/Center | 1239 Woodland Dr, Suite 105, Elizabethtown, KY 42701-2770 | 2013-05-09 |
1609154442 | Ernest Lee Towns | Counselor | 1239 Woodland Dr, Suite 116, Elizabethtown, KY 42701-2770 | 2011-07-27 |
1780971846 | Sheryl L Hanawalt | Podiatrist | 1239 Woodland Dr, Suite 101, Elizabethtown, KY 42701-2770 | 2011-07-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
Find all providers in zip 42701 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235792441 | Behavioral Health Plus Pllc | Nurse Practitioner | 110 Chase Way Ste 3, Elizabethtown, KY 42701-7827 | 2019-04-15 |
1487168936 | Aigne Mental Wellness | Nurse Practitioner | 2608 Ring Rd Ste 107, Elizabethtown, KY 42701-7945 | 2017-11-20 |
1134663925 | Advanced Behavioral Health, Pllc | Nurse Practitioner | 110 Helm Street, Elizabethtown, KY 42701-1496 | 2016-12-13 |
1659401461 | Jeffrey Prater | Nurse Practitioner | 110 Helm St, Elizabethtown, KY 42701 | 2007-03-07 |
1952357774 | Ingrid Medley | Nurse Practitioner | 151 Drexler Cir, Ste 1, Elizabethtown, KY 42701-7843 | 2006-05-25 |
1841259272 | Regina Lynn Woods | Nurse Practitioner | 2608 Ring Rd Ste B107, Elizabethtown, KY 42701 | 2006-03-23 |
1720688005 | Kevin Luke Houser | Nurse Practitioner | 120 Helmwood Plaza Dr Ste 103, Elizabethtown, KY 42701-3459 | 2020-10-27 |
1548868268 | Cheri Michelle Frederick | Nurse Practitioner | 2000 Ring Rd, Elizabethtown, KY 42701-9454 | 2020-10-14 |
1558976803 | Kristen Howell | Nurse Practitioner | 2000 Ring Rd, Elizabethtown, KY 42701-9454 | 2020-09-14 |
1457992570 | Marinda Moore Schneider | Nurse Practitioner | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-09-30 |
Find all providers in ELIZABETHTOWN |
City | ELIZABETHTOWN |
Zip Code | 42701 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.