Mike Duffy, MED
Individual provider Active NPI Counselor · Maysville, KY
NPI 1144360900 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1144360900
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 611 Forest Ave
Maysville, KY 41056-1411 - Phone
- (606) 564-4016
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
611 Forest Ave
Maysville, KY 41056-1411
Mailing address
611 Forest Ave
Maysville, KY 41056-1411
Phone (606) 564-4016
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30608012 | Medicaid | KY |
Other providers in Maysville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.