NPI 1063202794

Square One LLC

Organisation Developmental - Behavioral Pediatrics Physician Louisville, KY

Practice location

Address: 6440 Dutchmans Pkwy Fl 2, Louisville, KY 40205-3352
Phone: (502) 896-2606
Fax: (502) 896-0487

Authorised official

Name: Cassidy Niehaus
Title: Office Manager
Phone: (502) 896-2606

Registered specialties (3)

Developmental - Behavioral Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2080P0006X

Other Pediatrics providers in Kentucky →

Clinical Neuropsychologist

Behavioral Health & Social Service Providers Taxonomy 103G00000X

Other Clinical Neuropsychologist providers in Kentucky →

Clinical Child & Adolescent Psychologist

Behavioral Health & Social Service Providers Taxonomy 103TC2200X

Other Psychologist providers in Kentucky →

Registry record

NPI: 1063202794
Entity type: Organization
NPI issued: 7 May 2025
Record last updated: 7 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.