NPIMap

Organization Active NPI

Bluegrass Counseling & Trauma Services

  • Mental Health Counselor
  • Lexington, KY
National Provider Identifier
1366197147
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BLUEGRASS COUNSELING & TRAUMA SERVICES
Practice address
503 Darby Creek Rd Ste C
Lexington, KY 40509-1603
Phone
(859) 368-2567
Fax
(859) 788-3905
NPI assigned
Feb 19, 2022
Last updated
Apr 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Crystal Stapleton
Title
Contracting Director
Phone
(270) 380-1093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

503 Darby Creek Rd Ste C
Lexington, KY 40509-1603

Mailing address

503 Darby Creek Rd Ste C
Lexington, KY 40509-1603
Phone (859) 368-2567

Other practice location 1

824 Euclid Ave # A102
Lexington, KY 40502-1785
Phone (859) 338-0006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220823001966 KY Part B Supplier - Clinic/Group Practice 0042693137 Receives reassigned benefits from 8 practitioners
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Locations

503 Darby Creek Rd
Ste C
Lexington, KY 40509
Phone (859) 368-2567

824 Euclid Ave
#A102
Lexington, KY 40502
Phone (859) 338-0006

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1645228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1366197147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 DARBY CREEK RD STE C",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091603",
            "telephone_number": "859-368-2567",
            "fax_number": "859-788-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 DARBY CREEK RD STE C",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091603",
            "telephone_number": "859-368-2567",
            "fax_number": "859-788-3905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "824 Euclid Ave # A102",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405021785",
            "country_code": "US",
            "telephone_number": "859-338-0006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUEGRASS COUNSELING & TRAUMA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-19",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "STAPLETON",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "CONTRACTING DIRECTOR",
        "authorized_official_telephone_number": "270-380-1093"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.