Jacqueline Hailey Cardin, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

240705 Issued in KY

Practice address

104 S Front Ave
Prestonsburg, KY 41653-1614

Phone

(606) 886-8572

Fax

(606) 886-4433

NPI assigned

Apr 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Hailey Wells Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kentucky Post-Acute Medical Services 1 PSC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Flemingsburg, KY
  • NPI 1831628783
  Medicare reassignment NPD
• Mountain Comprehensive Care Center, Inc.

  • Mental Health Counselor
  • Prestonsburg, KY
  • NPI 1760491674
  Medicare reassignment NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  KY

  Medicare reassignment NPD
• Mountain Comprehensive Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Paintsville, KY
  • NPI 1578811774
  NPD
• Mountain Comprehensive Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Paintsville, KY
  • NPI 1699386078
  NPD

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1083101190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDIN",
        "first_name": "JACQUELINE",
        "middle_name": "HAILEY",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "240705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "WELLS",
            "middle_name": "HAILEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Cantrell
• Tiffany Cantrell
• Tonya Cantrell
• Zachary Cantrell
• Lori Caraway, PERSP
• Cardio Sleep Solutions Kentucky LLC
• Caring Professionals
• Susan Carlin
• Kendall Carpenter
• Lindsey Carpenter

• Professional Counselor in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.