Individual provider Active NPI

Kenya Manley

  • Clinical Social Worker
  • Georgetown, KY
National Provider Identifier
1487121869
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
256089 Issued in KY
Practice address
105 Windsor Path Ste 5
Georgetown, KY 40324-9819
Phone
(216) 468-5000
Fax
(216) 456-8128
NPI assigned
Oct 24, 2018
Last updated
Oct 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 256089 KY Primary

Addresses

Primary practice location

105 Windsor Path Ste 5
Georgetown, KY 40324-9819

Mailing address

105 Windsor Path Ste 5
Georgetown, KY 40324-9819
Phone (216) 468-5000

Other practice location 1

104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572

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
I20211021001968 KY Practitioner - Clinical Social Worker 0547658619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Louisville School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

105 Windsor Path
Suite 5
Georgetown, KY 40324-9819
Phone (216) 468-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC Mental Health CurrentSince Dec 1, 2021 Accepting new patients

Locations

105 Windsor Path
Ste 5
Georgetown, KY 40324
Phone (502) 370-4240

100 Executive Park
Ste 103
Louisville, KY 40207
Phone (502) 313-6880

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1487121869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WINDSOR PATH STE 5",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249819",
            "telephone_number": "216-468-5000",
            "fax_number": "216-456-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WINDSOR PATH STE 5",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249819",
            "telephone_number": "216-468-5000",
            "fax_number": "216-456-8128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 S Front Ave",
            "address_purpose": "LOCATION",
            "city": "Prestonsburg",
            "state": "KY",
            "postal_code": "416531614",
            "country_code": "US",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "KENYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.