Kevin B Record, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4840 Issued in TN

Practice address

844 Natchez Trace Dr
Lexington, TN 38351

Phone

(731) 967-8803

Fax

(731) 967-8784

NPI assigned

Dec 9, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Mental Health Centers & Clinics of Tennessee

  • Mental Health Counselor
  • Bolivar, TN
  • NPI 1255442794
  NPD

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1417594482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 OLD HIGHWAY 64",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380083587",
            "telephone_number": "731-658-6113",
            "fax_number": "731-658-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 NATCHEZ TRACE DR",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "38351",
            "telephone_number": "731-967-8803",
            "fax_number": "731-967-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECORD",
        "first_name": "KEVIN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "4840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevin.record@quincomhc.org",
            "affiliation": "N",
            "address_1": "844 Natchez Trace Dr",
            "city": "Lexington",
            "state": "TN",
            "country_code": "US",
            "postal_code": "38351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Lexington, TN
• Providers in Lexington, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.