Organization Active NPI

Commonwealth Counseling Corp

  • Clinical Social Worker
  • Hopkinsville, KY
National Provider Identifier
1659474518
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
KY03 Issued in KY
Legal business name
COMMONWEALTH COUNSELING CORP
Practice address
1609 S Main St
Hopkinsville, KY 42240-1970
Phone
(270) 881-1062
Fax
(270) 887-0785
NPI assigned
Sep 6, 2006
Last updated
Oct 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Peggy H. Mullins, MSWNPI 1336195544
Title
Owner
Phone
(270) 881-1062

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X KY1182 KY
Clinical Social Worker 1041C0700X KY03 KY Primary

Addresses

Primary practice location

1609 S Main St
Hopkinsville, KY 42240-1970

Mailing address

1861 E. 9TH St.
Hopkinsville, KY 42240-1970
Phone (270) 881-1062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050913000882 KY Part B Supplier - Clinic/Group Practice 7618900457 Receives reassigned benefits from 2 practitioners
Practice locations: Hopkinsville, KY

National Provider Directory

National Provider Directory

Locations

1861 E 9th St
Hopkinsville, KY 42240
Phone (270) 886-3717

203B Commerce Ct
Hopkinsville, KY 42240

310 Cool Water Ct
Hopkinsville, KY 42240
Phone (270) 632-4675

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1659474518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 E. 9TH ST.",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401970",
            "telephone_number": "270-881-1062",
            "fax_number": "270-887-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 S MAIN ST",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401970",
            "telephone_number": "270-881-1062",
            "fax_number": "270-887-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH COUNSELING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-881-1062",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "KY1182",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "KY03",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.