Divine Soul Therapy LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

DIVINE SOUL THERAPY LLC

Practice address

1099 Indian Mound Dr Ste a
Mount Sterling, KY 40353-1652

Phone

(859) 517-4633

Fax

(859) 203-0843

NPI assigned

Jun 26, 2025

Organization subpart

No

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

Authorized official

Name

Casey Sue Logan, M.ED., LPCCNPI 1477748473

Title

Owner / Clinical Counselor

Phone

(859) 517-4633

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Practitioners 1

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

• Casey Sue Logan, M.ED., LPCC

  • Mental Health Counselor
  • Mount Sterling, KY
  • NPI 1477748473
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1659269504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 HINKSTON PIKE",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403539301",
            "telephone_number": "859-517-4633",
            "fax_number": "859-203-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 INDIAN MOUND DR STE A",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403531652",
            "telephone_number": "859-517-4633",
            "fax_number": "859-203-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE SOUL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER / CLINICAL COUNSELOR",
        "authorized_official_telephone_number": "859-517-4633",
        "authorized_official_credential": "M.ED., LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Mount Sterling, KY
• Providers in Mount Sterling, 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 Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.