Mircea Backhurst
Individual provider Active NPI Counselor · Lexington, KY
NPI 1164296752 · NPPES record last updated Nov 14, 2023
Key facts
- NPI
- 1164296752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277 - Phone
- (859) 253-1686
- NPI assigned
- Nov 14, 2023
- Sex
- Female
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | KY | Yes |
Addresses
Primary practice location
1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277
Mailing address
1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2023. 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.