Provider Demographics
NPI:1194033431
Name:DR. JAMES F. SHIELDS PSY.D. PLLC
Entity Type:Organization
Organization Name:DR. JAMES F. SHIELDS PSY.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:502-423-7222
Mailing Address - Street 1:8141 NEW LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4682
Mailing Address - Country:US
Mailing Address - Phone:502-423-7222
Mailing Address - Fax:502-423-7277
Practice Address - Street 1:8141 NEW LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4682
Practice Address - Country:US
Practice Address - Phone:502-423-7222
Practice Address - Fax:502-423-7277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY0897103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty