Provider Demographics
NPI:1689220386
Name:KATHRYN HAENDIGES PSYD
Entity Type:Organization
Organization Name:KATHRYN HAENDIGES PSYD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAENDIGES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:502-377-4758
Mailing Address - Street 1:1856 ALFRESCO PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1860
Mailing Address - Country:US
Mailing Address - Phone:502-377-4758
Mailing Address - Fax:
Practice Address - Street 1:1941 BISHOP LN STE 711
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1937
Practice Address - Country:US
Practice Address - Phone:502-377-4758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-18
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty