Active NPI
Maegan Mayne, LCSW
- Clinical Social Worker
- Girdler, KY
National Provider Identifier
1437783271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 256666
- Practice address
- 5483 N Ky 11
Girdler, KY 40906 - Phone
- (606) 627-9250
- NPI assigned
- Mar 2, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 256666 | KY | Primary |
Addresses
Primary practice location
5483 N Ky 11
Girdler, KY 40906
Mailing address
5483 N Ky 11
Barbourville, KY 40906-0621
Phone (606) 627-9250
Other practice location 1
925 Dudley Pike
Edgewood, KY 41017-8120
Phone (859) 360-3006
Other practice location 2
1436 S Shelby St
Louisville, KY 40217-1195
Phone (502) 635-4530
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 256666 | KY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayne Stream Counseling, LLC | Clinical | Current | Accepting new patients |
| Kentucky Counseling Center, LLC | Current | Accepting new patients | |
| Bluegrass Behavioral Health Group, LLC | Clinical | Current | Accepting new patients |
Locations
1169 Eastern Pkwy
Ste 3328
Louisville, KY 40217
Phone (205) 914-2526
Organizations & group practices 3
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": "1583107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670198400000",
"number": "1437783271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5483 N KY 11",
"city": "BARBOURVILLE",
"state": "KY",
"postal_code": "409060621",
"telephone_number": "606-627-9250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5483 N KY 11",
"city": "GIRDLER",
"state": "KY",
"postal_code": "40906",
"telephone_number": "606-627-9250"
}
],
"practiceLocations": [
{
"address_1": "925 Dudley Pike",
"address_purpose": "LOCATION",
"city": "Edgewood",
"state": "KY",
"postal_code": "410178120",
"country_code": "US",
"telephone_number": "859-360-3006",
"fax_number": "859-360-3053",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1436 S Shelby St",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402171195",
"country_code": "US",
"telephone_number": "502-635-4530",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAYNE",
"first_name": "MAEGAN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-02",
"last_updated": "2022-12-05",
"certification_date": "2022-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "256666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Girdler, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.