Individual provider Active NPI

Michael Henney

  • Addiction (Substance Use Disorder) Counselor
  • Buckner, KY
National Provider Identifier
1336864115
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
276756 Issued in KY
Practice address
4414 Old Lagrange Rd
Buckner, KY 40010-9547
Phone
(502) 222-2389
Fax
(502) 222-2927
NPI assigned
Oct 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 276756 KY Primary

Addresses

Primary practice location

4414 Old Lagrange Rd
Buckner, KY 40010-9547

Mailing address

PO Box 1484
Crestwood, KY 40014-1484
Phone (502) 222-2389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
276756KYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prodigal Ministries, LLC CurrentSince Oct 9, 2022 Accepting new patients
Prodigal Ministries, LLC CurrentSince Jan 7, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1336864115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1484",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400141484",
            "telephone_number": "502-222-2389",
            "fax_number": "502-222-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 OLD LAGRANGE RD",
            "city": "BUCKNER",
            "state": "KY",
            "postal_code": "400109547",
            "telephone_number": "502-222-2389",
            "fax_number": "502-222-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEY",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "276756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckner, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.