ANASTASIA STACY WYATT


Address: 118 West Union Street, Munfordville, KY 42765
Phone: 2705249883

ANASTASIA STACY WYATT (NPI# 1245365527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245365527
Entity Type Individual
Full Name ANASTASIA STACY WYATT
Credential CADC
Practice Address 118 West Union Street
Munfordville
KY 42765
Mailing Address 1686 Morehead Rd
Bowling Green
KY 42101-6304
Practice Telephone 2705249883
Practice Fax Number 2705240437
Enumeration Date 2007-02-23
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
0762 KY Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
KY 30604011 05

Office Location

Street Address 118 WEST UNION STREET
City MUNFORDVILLE
State KY
Zip Code 42765

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174132997 All Smiles Therapy, LLC Speech-Language Pathologist 114 W Union Street, Munfordville, KY 42765 2020-07-28
1922385129 Wanda Sexton Counselor 103 E. South St., Munfordville, KY 42765 2011-11-16
1215217328 Brandy Gayle Pierce Registered Nurse 117 West South St., Munfordville, KY 42765 2011-08-19
1447588488 Jackie A. Pandeya Nurse Practitioner 950 Main St., Munfordville, KY 42765 2009-12-03
1295955961 Jill Lynn Humphrey Speech-Language Pathologist 3316 Macon Kessinger Rd, Munfordville, KY 42765 2007-04-26
1790801694 Christina L Johns Counselor 118 West Union St., Munfordville, KY 42765 2007-03-22
1083741326 Louisville Optometric Center, IIi, Psc Optometrist 815 Main St., Munfordville, KY 42765 2007-02-27
1306987847 Laura A Gaines Social Worker 118 West Union St, Munfordville, KY 42765 2007-02-09
1427015890 Hart County Ambulance Service,taxing District Ambulance 20 Ambulance Drive, Munfordville, KY 42765 2006-04-28
1881659951 Family Medical Center of Hart Co Pediatrics 117 W South St, Munfordville, KY 42765 2006-04-20
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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1700496569 Nicole Kristina Doza Counselor 9720 Park Plaza Ave Unit 104, Louisville, KY 40241-2289 2020-08-06
1447860572 Jordan Mceuen Counselor 645 S Roy Wilkins Ave Ste 100, Louisville, KY 40203-2072 2020-08-04
1285252080 Shamara Huguely Counselor 455 Park Pl # 130, Lexington, KY 40511-1881 2020-07-08
1023633674 Ky Behavioral Solutions Counselor 12700 Townepark Way Ste 341, Louisville, KY 40243-2381 2020-06-10
1730702788 Ruth Gonia Counselor 2810 Rosewood Rd, La Grange, KY 40031-9323 2020-05-26
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Competitor

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City MUNFORDVILLE
Zip Code 42765

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Dataset Information

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.

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