Organization Active NPI

Divine Transitions LLC

  • Mental Health Counselor
  • Paducah, KY
National Provider Identifier
1023827854
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DIVINE TRANSITIONS LLC
Practice address
131 Nahm St Ste 9
Paducah, KY 42001-4362
Phone
(270) 625-5005
Fax
(270) 713-0638
NPI assigned
Jan 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Authorized official

Name
Holly Wiggs
Title
Medical Billing Specialist
Phone
(765) 760-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

131 Nahm St Ste 9
Paducah, KY 42001-4362

Mailing address

131 Nahm St Ste 9
Paducah, KY 42001-4362
Phone (270) 625-5005

Other identifiers 1

IdentifierTypeStateIssuer
7100866450MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250206002018 KY Part B Supplier - Clinic/Group Practice 7911437975 Receives reassigned benefits from 2 practitioners
Practice locations: Marion, KY; Paducah, KY

National Provider Directory

National Provider Directory

Locations

130 Fountain Ave
Paducah, KY 42001

131 Nahm St
Ste 9
Paducah, KY 42001
Phone (270) 443-9285

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1023827854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 NAHM ST STE 9",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014362",
            "telephone_number": "270-625-5005",
            "fax_number": "270-713-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 NAHM ST STE 9",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014362",
            "telephone_number": "270-625-5005",
            "fax_number": "270-713-0638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE TRANSITIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "WIGGS",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "MEDICAL BILLING SPECIALIST",
        "authorized_official_telephone_number": "765-760-3500"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100866450",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.