Carissa Stallsworth

Individual provider Active NPI Mental Health Counselor · Brodhead, KY

NPI 1508595083 · NPPES record last updated Jul 22, 2026

Key facts

NPI
1508595083
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
294481 (KY)
Practice address
1246 Brindle Ridge Rd
Brodhead, KY 40409-8412
Phone
(859) 230-6734
NPI assigned
Jun 9, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
294481KYMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 294481 KY Yes

Addresses

Primary practice location

1246 Brindle Ridge Rd
Brodhead, KY 40409-8412

Mailing address

1246 Brindle Ridge Rd
Brodhead, KY 40409-8412

Other providers in Brodhead, KY

All providers in Brodhead, KY · Mental Health Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.