Provider Demographics
NPI:1497946529
Name:LARRY SPRINGATE
Entity Type:Organization
Organization Name:LARRY SPRINGATE
Other - Org Name:CENTER FOR RELATIONSHIPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SPRINGATE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:859-277-0022
Mailing Address - Street 1:101 WIND HAVEN DR
Mailing Address - Street 2:#202
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-8035
Mailing Address - Country:US
Mailing Address - Phone:859-277-0022
Mailing Address - Fax:859-277-0077
Practice Address - Street 1:101 WIND HAVEN DR
Practice Address - Street 2:#202
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-8035
Practice Address - Country:US
Practice Address - Phone:859-277-0022
Practice Address - Fax:859-277-0077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1082103T00000X
KY0432106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty