Kevin J Pangburn, LCADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Floyds Knobs, IN
NPI 1356920532 · NPPES record last updated Apr 7, 2021
Key facts
- NPI
- 1356920532
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 4200 Buck Creek Rd
Floyds Knobs, IN 47119-9216 - Phone
- (502) 861-6661
- NPI assigned
- Apr 6, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
4200 Buck Creek Rd
Floyds Knobs, IN 47119-9216
Mailing address
4200 Buck Creek Rd
Floyds Knobs, IN 47119-9216
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100730680 | Medicaid | KY |
Other providers in Floyds Knobs, IN
- Cody Ray Mumaw
- Robert Joseph Naville III
- Nathan S Nevin
- Kayla Lee Newcomb
- NPF Foot and Ankle
- Vyoma Y Pathakjee
- Adreian Alexander Paul
- Pediatric Specialty Rehab, Inc.
- Philip S Seng Inc
- Physician Associates of Floyds Knobs, LLC
All providers in Floyds Knobs, IN · Addiction (Substance Use Disorder) Counselor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.