Anderson, Justin O'Neal

Anderson, Justin O'Neal is an sole proprietor health care provider with primary practice located at 1015 S 4Th St , Louisville KY 40203-3207. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Anderson, Justin O'Neal can be contacted via phone (502) 272-9718.

Contact Information

Primary practice address
1015 S 4Th St Louisville KY 40203-3207
Phone: (502) 272-9718
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1732 Kentucky
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1723 Alabama

Profile Details

NPI number 1780834390
LBN Legal business name Anderson, Justin O'Neal
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 19th, 2008
Last updated Jun 29th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780834390 NPPES
Other 46-2967720 TAX ID

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