Charlie Elrod

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

283695 Issued in KY

Practice address

156 N Lake Dr
Prestonsburg, KY 41653-1270

Phone

(606) 506-5077

Fax

(606) 506-5039

NPI assigned

Jul 31, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Traverse Behavioral Health Services LLC

  • Mental Health Counselor
  • Paintsville, KY
  • NPI 1275214009

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  KY

  Medicare reassignment

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1598243735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 8TH ST",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401284",
            "telephone_number": "606-209-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 N LAKE DR",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531270",
            "telephone_number": "606-506-5077",
            "fax_number": "606-506-5039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 8th St",
            "address_purpose": "LOCATION",
            "city": "Paintsville",
            "state": "KY",
            "postal_code": "412401284",
            "country_code": "US",
            "telephone_number": "606-209-1548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELROD",
        "first_name": "CHARLIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "273775",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "283695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Elledge, LPCC
• Rebecca Elligson
• Malinda Elliott
• Brandi Ellis
• Georgia Ellis, LPCC
• Jordan Embry, LCSW
• Emcare Physician Providers, Inc.
• Emergent Care EMS, LLC
• Annie Emert
• Sara Emmons

• Mental Health Counselor in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.