Individual provider Active NPI

Shelby Grace Yeich, MA, LPCC

  • Mental Health Counselor
  • Lexington, KY
National Provider Identifier
1376376400
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
294221 Issued in KY
Practice address
3150 Custer Dr Ste 202
Lexington, KY 40517-4010
Phone
(502) 219-3488
NPI assigned
Aug 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 294221 KY Primary

Addresses

Primary practice location

3150 Custer Dr Ste 202
Lexington, KY 40517-4010

Mailing address

3150 Custer Dr Ste 202
Lexington, KY 40517-4010
Phone (502) 219-3488

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241009004148 KY Practitioner - Mental Health Counselor 2163954553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Kentucky Services, LLCGroup PAC ID 1254716780, 9 clinicians

Practice addresses (Care Compare)

3150 Custer Dr
Suite 203
Lexington, KY 40517-4010
Phone (502) 219-3488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
294221KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Services, LLC CurrentSince Aug 27, 2024 Accepting new patients
Kentucky Services, LLC CurrentSince Aug 27, 2024 Accepting new patients

Locations

201 W Walnut St
Ste 2
Danville, KY 40422
Phone (502) 219-3488

3150 Custer Dr
Ste 202
Lexington, KY 40517
Phone (502) 219-3488

3150 Custer Dr
Ste 203
Lexington, KY 40517
Phone (502) 219-3488

3167 Custer Dr
Ste 101
Lexington, KY 40517
Phone (859) 227-2077

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": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1376376400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 CUSTER DR STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174010",
            "telephone_number": "502-219-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CUSTER DR STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174010",
            "telephone_number": "502-219-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEICH",
        "first_name": "SHELBY",
        "middle_name": "GRACE",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "294221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.