MAGNOLIA PSYCHIATRY
NPI 1255090510
Nurse Practitioner - Psychiatric/Mental Health in Louisville, KY

Active since December 14, 2021
312 S 4TH ST STE 700, LOUISVILLE, KY 40202(615) 813-0726 Get Directions Write a Review

NPPES record last updated: February 3, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 3, 2022, Dec 14, 2021 (2 updates tracked since 2021).

About Magnolia Psychiatry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAGNOLIA PSYCHIATRY (NPI 1255090510) is a healthcare organization registered as a psychiatric/mental health in Louisville, Kentucky and active in the NPI registry since December 2021. The organization maintains a secondary practice location in Bowling Green and lists Angel Squire, Owner, as its authorized official.

NPPES Registry Identity

NPI1255090510
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameMAGNOLIA PSYCHIATRY
Location Address312 S 4TH ST STE 700Louisville, KY 40202-3046
Mailing Address4523 Shady Place CtBowling Green, KY 42104-4423 · (937) 285-0414
Organization SubpartNo
Authorized OfficialAngel SquireOwner · (615) 813-0726
Enumeration DateDecember 14, 2021
Last NPPES UpdateFebruary 3, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2022
NPI 1255090510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
312 S 4TH ST STE 700, Louisville, KY 40202

Secondary Practice Location 1

Location 14523 Shady Place CtBowling Green, KY 42104-4423 · Phone (937) 285-0414

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
312 S 4TH ST STE 700
LOUISVILLE, KY 40202
Nurse Practitioner (Family)
312 S 4TH ST STE 700
LOUISVILLE, KY 40202
Case Manager/Care Coordinator
312 S 4TH ST STE 700
LOUISVILLE, KY 40202
Nurse Practitioner (Family)
312 S 4TH ST STE 700
LOUISVILLE, KY 40202
Nurse Practitioner (Family)
312 S 4TH ST STE 700
LOUISVILLE, KY 40202
Social Worker (Clinical)
312 S 4TH ST STE 700
LOUISVILLE, KY 40202
Nurse Practitioner (Family)
312 S 4TH ST STE 700
LOUISVILLE, KY 40202
Anesthesiology
312 S 4TH ST STE 700
LOUISVILLE, KY 40202

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Magnolia Psychiatry's NPI number?

The NPI number for Magnolia Psychiatry is 1255090510. It was assigned to this organization in the NPPES registry on December 14, 2021.

Where is Magnolia Psychiatry located?

Magnolia Psychiatry is located at 312 S 4th St Ste 700, Louisville, KY 40202. The listed phone number is (615) 813-0726.

What is Magnolia Psychiatry's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Magnolia Psychiatry was last updated on February 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.