Provider Demographics
NPI:1831487784
Name:KENTUCKIANA MENTAL HEALTH ASSOCIATES
Entity Type:Organization
Organization Name:KENTUCKIANA MENTAL HEALTH ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:STEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-895-4470
Mailing Address - Street 1:105 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1525
Mailing Address - Country:US
Mailing Address - Phone:502-895-4470
Mailing Address - Fax:502-895-2030
Practice Address - Street 1:105 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1525
Practice Address - Country:US
Practice Address - Phone:502-895-4470
Practice Address - Fax:502-895-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-13
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY321562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00533067OtherKY MEDICARE/NCMA
KY200422540OtherMEDICAID PIN
KY64042609OtherMEDICAID PIN
KYDB5875OtherRAILROAD MEDICARE
KY64042609OtherMEDICAID/NCMA
KY65942385OtherMEDICAID GROUP PIN
IN200478830AOtherMEDICAID GROUP PIN
KYP00115999OtherRAILROAD MEDICARE
KY65942385OtherMEDICAID GROUP PIN
KYP00115999OtherRAILROAD MEDICARE