Provider Demographics
NPI:1730317801
Name:HEALTH PSYCHOLOGY ASSOCIATES, PSC
Entity Type:Organization
Organization Name:HEALTH PSYCHOLOGY ASSOCIATES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MONSMA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-413-5228
Mailing Address - Street 1:PO BOX 8116
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40257-8116
Mailing Address - Country:US
Mailing Address - Phone:502-413-5228
Mailing Address - Fax:502-413-5995
Practice Address - Street 1:101 CRESCENT AVE STE A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1512
Practice Address - Country:US
Practice Address - Phone:502-413-5228
Practice Address - Fax:502-413-5995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0867103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYDQ6556OtherRR MEDICARE
KY7100112570Medicaid
KY01281Medicare PIN