Individual provider Active NPI

Richard Alexander McKinley

  • Professional Counselor
  • Campbellsville, KY
National Provider Identifier
1619303567
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
245620 Issued in KY
Practice address
1327 E Broadway St Ste B
Campbellsville, KY 42718-1599
Phone
(270) 283-4240
NPI assigned
Sep 24, 2013
Last updated
Sep 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X 245620 KY Primary

Addresses

Primary practice location

1327 E Broadway St Ste B
Campbellsville, KY 42718-1599

Mailing address

107 Cranes Roost CT
Elizabethtown, KY 42701-3650
Phone (270) 765-2605

Other practice location 1

1311 N Dixie Hwy
Elizabethtown, KY 42701-2621
Phone (270) 765-2605 ext. 1936

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
I20240118004202 KY Practitioner - Mental Health Counselor 5991124380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Counseling Center LLCGroup PAC ID 7618221300, 57 clinicians

Practice addresses (Care Compare)

1169 Eastern Pkwy
Suite 3328
Louisville, KY 40217-1415
Phone (855) 591-0092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Counseling Center, LLC Professional CurrentSince Jan 1, 2024 Accepting new patients
KCC Recovery, LLC Dba Bluegrass Recovery, LLC Professional Past Accepting new patients

Locations

1169 Eastern Pkwy
Ste 3328
Louisville, KY 40217
Phone (205) 914-2526

4835 Poplar Level Rd
Ste 110
Louisville, KY 40213
Phone (502) 424-5002

Organizations & group practices 2

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": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1619303567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CRANES ROOST CT",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013650",
            "telephone_number": "270-765-2605",
            "fax_number": "270-234-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 E BROADWAY ST STE B",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427181599",
            "telephone_number": "270-283-4240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1311 N Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427012621",
            "country_code": "US",
            "telephone_number": "270-765-2605 x1936",
            "fax_number": "270-234-8572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINLEY",
        "first_name": "RICHARD",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-24",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "245620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

Verify at the official NPI Registry.