NPIMap

Organization Active NPI

CCC of Western Kentucky

  • Mental Health Counselor
  • Paducah, KY
National Provider Identifier
1346756459
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
105399 Issued in KY
Legal business name
CCC OF WESTERN KENTUCKY
Practice address
2820 Jefferson St
Paducah, KY 42001-4170
Phone
(270) 442-5738
Fax
(270) 442-3172
NPI assigned
Dec 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2017

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

Authorized official

Name
Roger Thompson, MS, LMFT
Title
Director
Phone
(270) 442-5738

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 105399 KY Primary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 105699 KY
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 104561 KY

Addresses

Primary practice location

2820 Jefferson St
Paducah, KY 42001-4170

Mailing address

PO Box 8211
Paducah, KY 42002-8211
Phone (270) 442-5738

Other names 1

  • Christian Counseling Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514332800000",
    "number": "1346756459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8211",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420028211",
            "telephone_number": "270-442-5738",
            "fax_number": "270-442-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 JEFFERSON ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014170",
            "telephone_number": "270-442-5738",
            "fax_number": "270-442-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCC OF WESTERN KENTUCKY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-27",
        "last_updated": "2017-12-27",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "270-442-5738",
        "authorized_official_credential": "MS, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "105399",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "105699",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "104561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christian Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; 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.