Jolene Blevins, LPCA

Individual provider Active NPI Mental Health Counselor · Liberty, KY

NPI 1073014239 · NPPES record last updated Feb 23, 2018

Key facts

NPI
1073014239
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
175130 (KY)
Practice address
322 Middleburg St
Liberty, KY 42539-3004
Phone
(606) 787-9472
NPI assigned
Feb 23, 2018
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
175130KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cumberland Regional MHMR Board Outpatient Past Accepting new patients
Lake Cumberland Regional Mental Health Mental Retardation Board, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 175130 KY Yes

Addresses

Primary practice location

322 Middleburg St
Liberty, KY 42539-3004

Mailing address

130 Southern School Rd
Somerset, KY 42501-3223

Other providers in Liberty, KY

All providers in Liberty, KY · Mental Health Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.