Provider Demographics
NPI:1407024664
Name:WEISSKOPF CHILD EVALUATION CENTER
Entity Type:Organization
Organization Name:WEISSKOPF CHILD EVALUATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:HERSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-852-7897
Mailing Address - Street 1:571 S FLOYD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3818
Mailing Address - Country:US
Mailing Address - Phone:502-852-7897
Mailing Address - Fax:502-852-2911
Practice Address - Street 1:571 S FLOYD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3818
Practice Address - Country:US
Practice Address - Phone:502-852-7897
Practice Address - Fax:502-852-2911
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1085133VN1004X
KY201372080P0006X
KYR0815225XP0200X
KY583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Single Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY45656162OtherEPSDT
KY65901696Medicaid