Active NPI
Tarah Jean Kidd, MA
- Professional Counselor
- Williamsburg, KY
National Provider Identifier
1164757399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 243668
- Practice address
- 65 N Highway 25 W
Williamsburg, KY 40769-1540 - Phone
- (606) 549-0123
- NPI assigned
- Oct 6, 2009
- Last updated
- Mar 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0701008317 | VA | |
| Professional Counselor | 101YP2500X | 243668 | KY | Primary |
Addresses
Primary practice location
65 N Highway 25 W
Williamsburg, KY 40769-1540
Mailing address
PO Box 1721
La Follette, TN 37766-1721
Phone (859) 755-6871
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164757399 | Medicaid | KY | |
| 40588671 | Medicaid | TN |
Other names 1
- Melissa Denise Hardwick
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701008317 | VA | MD | Addiction (Substance Use Disorder) Counselor |
| 243668 | KY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1164757399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1721",
"city": "LA FOLLETTE",
"state": "TN",
"postal_code": "377661721",
"telephone_number": "859-755-6871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 N HIGHWAY 25 W",
"city": "WILLIAMSBURG",
"state": "KY",
"postal_code": "407691540",
"telephone_number": "606-549-0123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDD",
"first_name": "TARAH",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-06",
"last_updated": "2023-03-07",
"certification_date": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "VA",
"license": "0701008317",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "243668",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1164757399",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40588671",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "HARDWICK",
"middle_name": "DENISE",
"credential": "MA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Williamsburg, KY
- Lindsey Jones, APRN
- Melissa Ann Jones, P.T.A.
- Byron Douglas Karr, OD
- Kentucky Rural Health Information Technology Network Inc (Horizon Health)
- Kentucky Rural Health Information Technology Network, Inc. (Horizon Health)
- James Wendall Killian, M.D.
- Kims Hometown Pharmacy Inc (Kims Hometown Pharmacy)
- Barret Ashby Knight
- Ashley Konrad
- Sheila Denise Lambdin, APRN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.