Imani Blunt, LCSW
Individual provider Active NPI Clinical Social Worker · Prestonsburg, KY
NPI 1639657802 · NPPES record last updated Sep 28, 2022
Key facts
- NPI
- 1639657802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 257316 (KY)
- Practice address
- 104 S Front Ave
Prestonsburg, KY 41653-1614 - Phone
- (606) 886-8572
- Fax
- (606) 886-4433
- NPI assigned
- Jul 31, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 26
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mountain Comprehensive Care Center Inc
Practice addresses (Care Compare)
104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-4346
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221011002772 | KY | Practitioner - Clinical Social Worker | 2163898487 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 257316 | KY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Comprehensive Care Center, Inc. | Current |
Accepting new patients | |
| Mountain Comprehensive Care Center, Inc. | Current |
Accepting new patients | |
| Mountain Comprehensive Care Center, Inc. | Mental Health | Current | Accepting new patients |
Locations
1110 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345
838 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345
104 S Front Ave
Prestonsburg, KY 41653
Phone (606) 688-6857
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 257316 | KY | Yes |
Addresses
Primary practice location
104 S Front Ave
Prestonsburg, KY 41653-1614
Mailing address
104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572
Other providers in Prestonsburg, KY
- Bluegrass Family Agency Inc
- Bluegrass Family Chiropractic PLLC
- Bluegrass Nutrition Solutions
- Bluegrass Therapy PLLC
- Jason Scott Bluemlein
- Clinton Boarman
- Queenzlynn Boateng
- Brooklyn Boggs
- Candace Boggs
- Kayla Boggs
All providers in Prestonsburg, KY · Clinical Social Worker in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.