Provider Demographics
NPI:1730136995
Name:SENSIBLE PSYCHIATRIC SERVICES PLLC
Entity Type:Organization
Organization Name:SENSIBLE PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:F
Authorized Official - Last Name:LYDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-894-6066
Mailing Address - Street 1:4010 DUPONT CIR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4812
Mailing Address - Country:US
Mailing Address - Phone:502-894-6066
Mailing Address - Fax:502-371-5451
Practice Address - Street 1:4010 DUPONT CIR
Practice Address - Street 2:SUITE 300
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4812
Practice Address - Country:US
Practice Address - Phone:502-894-6066
Practice Address - Fax:502-371-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34791041C0700X
KY399582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2778613000OtherPASSPORT
2778613000OtherPASSPORT
KY00073Medicare ID - Type Unspecified