Individual provider Active NPI

Christina Edwards

  • Counselor
  • La Grange, KY
National Provider Identifier
1033309364
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
16325 Issued in KY
Practice address
2141 Spencer CT
La Grange, KY 40031-6742
Phone
(502) 589-8600
Fax
(502) 589-8771
NPI assigned
Aug 1, 2007
Last updated
Jun 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 16325 KY Primary

Addresses

Primary practice location

2141 Spencer CT
La Grange, KY 40031-6742

Mailing address

101 W Muhammad Ali Blvd
Louisville, KY 40202-1423

Other names 1

  • Christina Kirkham Former name

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
I20241015001684 KY Practitioner - Mental Health Counselor 0042742199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Counseling LLCGroup PAC ID 9830621986, 10 clinicians

Practice addresses (Care Compare)

214 Breckenridge LN
Suite 114
Louisville, KY 40207-3868
Phone (502) 653-7211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16325KYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Counseling, LLC CurrentSince Sep 1, 2024 Accepting new patients
Seven Counties Services, Inc. Counselor PastSince Jan 27, 2020 Accepting new patients

Locations

214 Breckenridge Ln
Ste 114
Louisville, KY 40207
Phone (502) 554-2439

802 Stone Creek Pkwy
Ste 1A
Louisville, KY 40223
Phone (502) 653-7211

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1033309364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 SPENCER CT",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400316742",
            "telephone_number": "502-589-8600",
            "fax_number": "502-589-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KY",
            "license": "16325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "KIRKHAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Grange, KY

Sources for this page

Verify at the official NPI Registry.