Individual provider Active NPI

Jana Noel Kidd, LPCC, LCADC

  • Professional Counselor
  • Grayson, KY
National Provider Identifier
1164936522
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
292106 Issued in KY
Practice address
840 Interstate Dr
Grayson, KY 41143-1768
Phone
(606) 329-8588
NPI assigned
Nov 21, 2017
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 268561 KY
Professional Counselor 101YP2500X 292106 KY Primary

Addresses

Primary practice location

840 Interstate Dr
Grayson, KY 41143-1768

Mailing address

PO Box 790
Ashland, KY 41105-0790
Phone (066) 329-8588

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
I20250114002491 KY Practitioner - Mental Health Counselor 3577091826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathways IncGroup PAC ID 1254239171, 60 clinicians

Practice addresses (Care Compare)

840 Interstate Dr
Grayson, KY 41143-1768
Phone (606) 474-5151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
268561KYMDAddiction (Substance Use Disorder) Counselor
292106KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Professional Counseling Services, PLLC Addiction (Substance Use Disorder) CurrentSince Jan 2, 2025 Accepting new patients
Pathways, Inc CurrentSince Apr 16, 2025 Accepting new patients
Pathways Inc CurrentSince Apr 16, 2025 Accepting new patients

Locations

1100 Our Ladys Way
Ste 219
Ashland, KY 41101
Phone (606) 388-4911

201 22nd St
Ashland, KY 41101
Phone (606) 324-1141

3701 Landsdowne Dr
Ashland, KY 41102
Phone (606) 324-3005

840 Interstate Dr
Grayson, KY 41143
Phone (606) 474-5151

Organizations & group practices 3

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": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1164936522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411050790",
            "telephone_number": "066-329-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 INTERSTATE DR",
            "city": "GRAYSON",
            "state": "KY",
            "postal_code": "411431768",
            "telephone_number": "606-329-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "JANA",
        "middle_name": "NOEL",
        "credential": "LPCC, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "268561",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "292106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayson, KY

Sources for this page

Verify at the official NPI Registry.