Individual provider Active NPI

Andrea Renee Conn, LPCC

  • Professional Counselor
  • Prestonsburg, KY
National Provider Identifier
1255846416
Registry record updated Oct 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
283400 Issued in KY
Practice address
104 S Front Ave
Prestonsburg, KY 41653-1614
Phone
(606) 886-8572
Fax
(606) 886-4433
NPI assigned
Dec 11, 2017
Last updated
Oct 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X 283400 KY Primary

Addresses

Primary practice location

104 S Front Ave
Prestonsburg, KY 41653-1614

Mailing address

104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572

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
I20240111003240 KY Practitioner - Mental Health Counselor 7911358155 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
283400KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Comprehensive Care Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Mountain Comprehensive Care Center, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Kentucky Counseling Center, LLC Professional CurrentSince Nov 17, 2025 Accepting new patients

Locations

1169 Eastern Pkwy
Ste 3328
Louisville, KY 40217
Phone (270) 216-2640

1110 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345

838 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345

104 S Front Ave
Prestonsburg, KY 41653
Phone (606) 688-6857

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": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791072000000",
    "number": "1255846416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "ANDREA",
        "middle_name": "RENEE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2026-10-04",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "283400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prestonsburg, KY

Sources for this page

Verify at the official NPI Registry.