Individual provider Active NPI

Kristy Macku, LMHC

  • Mental Health Counselor
  • Greensburg, IN
National Provider Identifier
1225252638
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39004096A Issued in IN
Practice address
1530 N Commerce W Dr
Greensburg, IN 47240-3205
Phone
(812) 663-7057
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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
Mental Health Counselor 101YM0800X 39004096A IN Primary

Addresses

Primary practice location

1530 N Commerce W Dr
Greensburg, IN 47240-3205

Mailing address

645 S Rogers St
Bloomington, IN 47403-2353
Phone (812) 339-1691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20231222001016 IN Practitioner - Mental Health Counselor 5597115113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerstone of Indiana IncGroup PAC ID 9436138427, 114 clinicians

Practice addresses (Care Compare)

3008 Bevcher Dr
Madison, IN 47250-3863
Phone (812) 265-1918

3008 N Bevcher Dr
Madison, IN 47250-3863
Phone (812) 265-1918

720 N Marr Rd
Columbus, IN 47201-6660
Phone (812) 314-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39004096AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Indiana, Inc. CurrentSince Nov 21, 2021 Accepting new patients
Centerstone of Indiana, Inc. CurrentSince Jan 1, 2025 Accepting new patients

Locations

645 S Rogers St
Bloomington, IN 47403
Phone (812) 339-1691

720 N Marr Rd
Columbus, IN 47201
Phone (812) 314-3400

1530 N Commerce West Dr
Greensburg, IN 47240
Phone (812) 663-7057

1713 E 10th St
Jeffersonvlle, IN 47130
Phone (812) 258-0310

3008 Bevcher Dr
Madison, IN 47250
Phone (812) 265-1918

1092 W Community Way
Scottsburg, IN 47170
Phone (812) 414-1520

1443 Corporate Way
Seymour, IN 47274
Phone (812) 522-4341

Organizations & group practices 2

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1225252638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N COMMERCE W DR",
            "city": "GREENSBURG",
            "state": "IN",
            "postal_code": "472403205",
            "telephone_number": "812-663-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKU",
        "first_name": "KRISTY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004096A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, IN

Sources for this page

Verify at the official NPI Registry.