Emily J Klingensmith, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

248597 Issued in KY

Practice address

Jones Park Elementary Healthy Kids Clinic 6295 E Ky 70
Liberty, KY 42539

Phone

(844) 435-0900

NPI assigned

Mar 3, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cumberland Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Burkesville, KY
  • NPI 1306873500
  Medicare reassignment NPD
• Cumberland Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Edmonton, KY
  • NPI 1548953672
  NPD
• Cumberland Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Russell Springs, KY
  • NPI 1437483815
  NPD (past)

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1356701353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JONES PARK ELEMENTARY HEALTHY KIDS CLINIC 6295 E KY 70",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "42539",
            "telephone_number": "844-435-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGENSMITH",
        "first_name": "EMILY",
        "middle_name": "J",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2024-08-12",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "LPCCCA00225150",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "248597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14478733",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100607120",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen C Johnson
• Miranda Maye Judd
• Kentucky CVS Pharmacy LLC
• Aviana Raine King, PHARMD
• Joshua Ryan King, NP-C
• Lake Cumberland District Health
• Lake Cumberland District Health Department
• Lake Cumberland District Health Dept
• Lake Cumberland District Health Dept
• Lake Cumberland District Health Dept.

• Mental Health Counselor in Liberty, KY
• Providers in Liberty, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.