| 12 Sherpas, Pllc | |
|
7984 New La Grange Rd Louisville KY 40222-4718 | |
| (502) 426-2777 | |
| (502) 426-2776 |
| Full Name | 12 Sherpas, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 7984 New La Grange Rd, Louisville, Kentucky |
| Authorized Official Name and Position | Amy B. Greenamyer (OWNER) |
| Authorized Official Contact | 5024262777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 12 Sherpas, Pllc 7984 New Lagrange Road Louisville KY 40222-4718 Ph: (502) 426-2777 | 12 Sherpas, Pllc 7984 New La Grange Rd Louisville KY 40222-4718 Ph: (502) 426-2777 |
| NPI Number | 1356713184 |
|---|---|
| Provider Enumeration Date | 10/20/2015 |
| Last Update Date | 08/08/2020 |
| Certification Date | 08/08/2020 |
| Medicare PECOS PAC ID | 5193025922 |
|---|---|
| Medicare Enrollment ID | O20151201002163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356713184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robert James Mattson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679821615 PECOS PAC ID: 1759623432 Enrollment ID: I20190429002332 |
| Provider Name | Kristen J. Haarman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922459619 PECOS PAC ID: 5092133371 Enrollment ID: I20200918000587 |
| Provider Name | Holly Michelle Brown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225598311 PECOS PAC ID: 1658788252 Enrollment ID: I20210326001480 |
| Provider Name | Abby Kelty |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629644067 PECOS PAC ID: 3678970324 Enrollment ID: I20210922001479 |
| Provider Name | Floyd Wally Cole |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447434972 PECOS PAC ID: 5799039079 Enrollment ID: I20220207002117 |
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