Southfork Counseling PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SOUTHFORK COUNSELING PLLC

Practice address

2500 Holt Rd
Paducah, KY 42001-8661

Phone

(859) 489-7384

Fax

(270) 558-3257

NPI assigned

Aug 31, 2026

Organization subpart

No

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

Authorized official

Name

Elmer C Maggard, PH.D.

Title

Owner

Phone

(859) 489-7384

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1184532335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 W JEFFERSON ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014336",
            "telephone_number": "859-489-7384",
            "fax_number": "270-558-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420018661",
            "telephone_number": "859-489-7384",
            "fax_number": "270-558-3257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFORK COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-30",
        "status": "A",
        "authorized_official_last_name": "MAGGARD",
        "authorized_official_first_name": "ELMER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-489-7384",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.