Active NPI
Jenny Bardena Durham, LPCA
- Professional Counselor
- London, KY
National Provider Identifier
1649812876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 268211
- Practice address
- 189 Ky-192
London, KY 40741 - Phone
- (606) 657-5470
- NPI assigned
- Oct 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 246663 | KY | |
| Professional Counselor | 101YP2500X | 268211 | KY | Primary |
Addresses
Primary practice location
189 Ky-192
London, KY 40741
Mailing address
PO Box 303
East Bernstadt, KY 40729-0303
Phone (606) 312-2437
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 246663 | KY | MD | Addiction (Substance Use Disorder) Counselor |
| 268211 | KY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651190400000",
"number": "1649812876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 303",
"city": "EAST BERNSTADT",
"state": "KY",
"postal_code": "407290303",
"telephone_number": "606-312-2437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "189 KY-192",
"city": "LONDON",
"state": "KY",
"postal_code": "40741",
"telephone_number": "606-657-5470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURHAM",
"first_name": "JENNY",
"middle_name": "BARDENA",
"credential": "LPCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-09",
"last_updated": "2022-04-29",
"certification_date": "2022-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "KY",
"license": "246663",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "268211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in London, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.