Mindclub Kentucky LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

MINDCLUB KENTUCKY LLC

Practice address

111 Derrick PL
Hopkinsville, KY 42240-1325

Phone

(833) 833-9655

NPI assigned

Jun 16, 2025

Organization subpart

No

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

Authorized official

Name

Kathy Richardson

Title

VP, Cao

Phone

(615) 390-2865

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1033005079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MISSION CT STE 201A",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676441",
            "telephone_number": "153-902-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DERRICK PL",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401325",
            "telephone_number": "833-833-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDCLUB KENTUCKY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "VP, CAO",
        "authorized_official_telephone_number": "615-390-2865"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mid-South Nursing Homes, Inc
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• Kayla Milauskas
• Millbrooke Elementary School
• Mindcare Mental Health Group
• Canice Clarice Minor
• Mitchell D Kaye PSC
• Larena Mitchell, LMT
• C. Hope Mitchuson
• Lacey Danielle Mobley

• Primary Care Nurse Practitioner in Hopkinsville, KY
• Providers in Hopkinsville, KY by specialty
• Primary Care Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.