Provider Demographics
NPI:1538564364
Name:JABLONSKI, MEGAN ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:JABLONSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-582-7484
Mailing Address - Fax:502-582-7646
Practice Address - Street 1:220 ABRAHAM FLEXNER WAY
Practice Address - Street 2:6TH FLOOR - PSYCHOLOGY DEPARTMENT
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3826
Practice Address - Country:US
Practice Address - Phone:502-582-7484
Practice Address - Fax:502-582-7646
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYPSYPST00074565103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201319500A (KOHMG)Medicaid
KY7100370730 (KOHMG)Medicaid
KYK179970 (KOHMG)Medicare PIN
KYP01525075 RR (KOHMG)Medicare PIN