Individual provider Active NPI

Tamika January, LPCA

  • Mental Health Counselor
  • Louisville, KY
National Provider Identifier
1073228094
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
282118 Issued in KY
Practice address
12921 Observation Cir Unit 202
Louisville, KY 40243-1678
Phone
(502) 403-6659
NPI assigned
Jan 16, 2023
Last updated
Jan 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 282118 KY Primary

Addresses

Primary practice location

12921 Observation Cir Unit 202
Louisville, KY 40243-1678

Mailing address

12921 Observation Cir Unit 202
Louisville, KY 40243-1678
Phone (502) 403-6659

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
I20260326001672 KY Practitioner - Mental Health Counselor 5890270052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12123 Shelbyville Rd
Suite 100
Louisville, KY 40243-1079

12123 Shelbyville Rd
Suite 100 413
Louisville, KY 40243-1044

PO Box
Suite 1429
Bardstown, KY 40004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
282118KYMDMental Health Counselor

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, 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": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1073228094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12921 OBSERVATION CIR UNIT 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431678",
            "telephone_number": "502-403-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12921 OBSERVATION CIR UNIT 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431678",
            "telephone_number": "502-403-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANUARY",
        "first_name": "TAMIKA",
        "credential": "LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "282118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.