Individual provider Active NPI

Mary Ann Cornish, LPCC-S

  • Professional Counselor
  • Lawrenceburg, KY
National Provider Identifier
1124684105
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
267762 Issued in KY
Practice address
1150 Bypass N
Lawrenceburg, KY 40342-9453
Phone
(844) 435-0900
Fax
(270) 858-4029
NPI assigned
May 15, 2019
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 246798 KY
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X 267762 KY Primary

Addresses

Primary practice location

1150 Bypass N
Lawrenceburg, KY 40342-9453

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other identifiers 1

IdentifierTypeStateIssuer
1790731081MedicaidKY

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
I20240201001828 KY Practitioner - Mental Health Counselor 3173976537 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
246798KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc Current Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Cumberland Family Medical Center Inc Past Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

1 Bearcat Dr
Lawrenceburg, KY 40342
Phone (502) 839-5118

1 Mustang Trl
Lawrenceburg, KY 40342
Phone (502) 839-9261

1150 Bypass N
Lawrenceburg, KY 40342
Phone (502) 839-4236

1154 Bypass N
Lawrenceburg, KY 40342
Phone (502) 839-2504

1411 Fox Creek Rd
Lawrenceburg, KY 40342
Phone (502) 839-2500

210 Saffell St
Lawrenceburg, KY 40342
Phone (502) 839-3565

Organizations & group practices 4

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": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1124684105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 BYPASS N",
            "city": "LAWRENCEBURG",
            "state": "KY",
            "postal_code": "403429453",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNISH",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "246798",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "267762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, KY

Sources for this page

Verify at the official NPI Registry.