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Kentucky River Community Care, Inc

Organization Active NPI Mental Health Counselor · Hazard, KY

NPI 1528017142 · NPPES record last updated Sep 19, 2023

Key facts

NPI
1528017142
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
Legal business name
KENTUCKY RIVER COMMUNITY CARE, INC
Practice address
115 Rockwood LN
Hazard, KY 41701-9415
Phone
(606) 436-4071
Fax
(606) 436-5797
NPI assigned
May 9, 2006
Organization subpart
No

Authorized official

Name
Marcia Adams
Title
Cfo
Phone
(606) 666-4351

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners 126

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 126

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mountain View Health
Emmalena, KY · CCN 188934		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 19, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040308000506 KY Part B Supplier - Clinic/Group Practice 3870481229 Receives reassigned benefits from 66 practitioners
Practice locations: Mayking, KY; Jackson, KY; Hyden, KY; Hazard, KY; Emmalena, KY; Beattyville, KY; Campton, KY

National Provider Directory

Tax ID family
Ky River Comm Care (6 organizations share this tax ID)

Locations

1060 Grand Ave
Beattyville, KY 41311
Phone (606) 464-0108

3476 Highway 80 W
Emmalena, KY 41740
Phone 6064365761 ext. 7220

305 Morton Blvd
Hazard, KY 41701
Phone (606) 435-1741

28 Fire House Ln
Hyden, KY 41749
Phone (606) 633-9964

3770 Highway 15 S
Jackson, KY 41339
Phone (606) 666-7591

3830 Highway 15 S
Jackson, KY 41339
Phone (606) 666-7591

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101Y00000X
Addiction (Substance Use Disorder) Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101YA0400X
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101YM0800X Yes
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101YP2500X
School Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101YS0200X
Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103T00000X
Clinical Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103TC0700X
School Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103TS0200X
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP		 1041C0700X
Specialist
Group: 193200000X MULTI-SPECIALTY GROUP		 174400000X
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225X00000X
Primary Care Clinic/Center 261QP2300X
Mental Illness Community Based Residential Treatment Facility 320800000X
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LP0808X

Addresses

Primary practice location

115 Rockwood LN
Hazard, KY 41701-9415

Mailing address

115 Rockwood LN
Hazard, KY 41701-9415
Phone (606) 436-5761

Other identifiers

IdentifierTypeStateIssuer
30612022MedicaidKY

Other providers in Hazard, KY

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

Sources for this page

Verify at the official NPI Registry.