Autumn Minch, LPCC

Individual provider Active NPI Professional Counselor · Munfordville, KY

NPI 1336630490 · NPPES record last updated Apr 30, 2024

Key facts

NPI
1336630490
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
291507 (KY)
Practice address
118 W Union St
Munfordville, KY 42765-8911
Phone
(270) 901-5000
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifeskills, Inc (47 clinicians)

Practice addresses (Care Compare)

118 W Union St
Munfordville, KY 42765-8911
Phone (270) 901-5000

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240524000410 KY Practitioner - Mental Health Counselor 9133561905 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
291507KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeskills, Inc. Current
since Apr 19, 2024
Accepting new patients

Locations

8324 Eagle Way
Chicago, IL 60678

380 Suwannee Trail St
Bowling Green, KY 42103

205 Mohawk St
Brownsville, KY 42210
Phone (270) 597-2713

608 Happy Valley Rd
Glasgow, KY 42141
Phone (270) 651-8379

118 W Union St
Munfordville, KY 42765
Phone (270) 524-2713

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 291507 KY
Professional Counselor 101YP2500X 291507 KY Yes

Addresses

Primary practice location

118 W Union St
Munfordville, KY 42765-8911

Mailing address

380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000

Other practice location 1

380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000

Other practice location 2

205 Mohawk St
Brownsville, KY 42210-8556
Phone (270) 901-5000

Other providers in Munfordville, KY

All providers in Munfordville, KY · Professional Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.