Individual provider Active NPI

Michelle Faith Muncy, LMFT, CBIS, TCADC

  • Marriage & Family Therapist
  • Georgetown, KY
National Provider Identifier
1023568698
Registry record updated Feb 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
245599 Issued in KY
Practice address
168 Hemingway PL
Georgetown, KY 40324-2318
Phone
(769) 355-9039
NPI assigned
Oct 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 171363 KY
Marriage & Family Therapist 106H00000X 245599 KY Primary

Addresses

Primary practice location

168 Hemingway PL
Georgetown, KY 40324-2318

Mailing address

168 Hemingway PL
Georgetown, KY 40324-2318
Phone (769) 355-9039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251104000507 KY Practitioner - Marriage and Family Therapist 1153843198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Farmers Bank SQ
Suite 105
Georgetown, KY 40324-8712

701 Park of Commerce Blvd
Boca Raton, FL 33487-3602

PO Box
Suite 186859
Hamden, CT 06518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
171363KYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Solutions Addiction (Substance Use Disorder) CurrentSince Oct 28, 2024 Accepting new patients

Locations

100 Farmers Bank Sq
Ste 105
Georgetown, KY 40324
Phone (502) 542-8721

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581724800000",
    "number": "1023568698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 HEMINGWAY PL",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403242318",
            "telephone_number": "769-355-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 HEMINGWAY PL",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403242318",
            "telephone_number": "769-355-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNCY",
        "first_name": "MICHELLE",
        "middle_name": "FAITH",
        "credential": "LMFT, CBIS, TCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-07",
        "last_updated": "2020-02-15",
        "certification_date": "2020-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "171363",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "245599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.