Individual provider Active NPI

Charlene Brown McDonald, LPCA

  • Mental Health Counselor
  • Ft. Thomas, KY
National Provider Identifier
1164930673
Registry record updated Mar 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
282937 Issued in KY
Practice address
24 S. Ft. Thomas Ave. Unit 75289
Ft. Thomas, KY 41075-0289
Phone
(513) 580-7390
NPI assigned
Jan 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2023

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
Professional Counselor 101YP2500X 246724 KY
Mental Health Counselor 101YM0800X 282937 KY Primary

Addresses

Primary practice location

24 S. Ft. Thomas Ave. Unit 75289
Ft. Thomas, KY 41075-0289

Mailing address

24 S Fort Thomas Ave Unit 75289
Fort Thomas, KY 41075-7512
Phone (513) 580-7390

Other practice location 1

2347 Vine St
Cincinnati, OH 45219-1745
Phone (513) 621-1117

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
I20240829004181 KY Practitioner - Mental Health Counselor 5193264448 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
282937KYMDMental Health Counselor
246724KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Counseling Mental Health CurrentSince Jun 1, 2024 Accepting new patients

Locations

4010 DuPont Cir
Ste B173
Louisville, KY 40207
Phone (502) 825-1375

300 Maple St
Ste 2
Murray, KY 42071
Phone (270) 339-4201

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677974400000",
    "number": "1164930673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 S FORT THOMAS AVE UNIT 75289",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410757512",
            "telephone_number": "513-580-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 S. FT. THOMAS AVE. UNIT 75289",
            "city": "FT. THOMAS",
            "state": "KY",
            "postal_code": "410750289",
            "telephone_number": "513-580-7390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2347 Vine St",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452191745",
            "country_code": "US",
            "telephone_number": "513-621-1117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "CHARLENE",
        "middle_name": "BROWN",
        "credential": "LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "246724",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "282937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Thomas, KY

Sources for this page

Verify at the official NPI Registry.