Individual provider Active NPI

Jeanne Nakazawa, MA, LPCC, NCC

  • Mental Health Counselor
  • Berea, KY
National Provider Identifier
1659818037
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
246414 Issued in KY
Practice address
292 Glades Rd Ste 8
Berea, KY 40403-1368
Phone
(859) 985-7862
NPI assigned
Jan 24, 2017
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 246414 KY Primary
Professional Counselor 101YP2500X 246414 KY

Addresses

Primary practice location

292 Glades Rd Ste 8
Berea, KY 40403-1368

Mailing address

PO Box 802
Berea, KY 40403-0802
Phone (859) 985-7862

Other identifiers 1

IdentifierTypeStateIssuer
7100606150MedicaidKY

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
246414KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Parsons Counseling, LLC Mental Health PastSince Apr 15, 2022 Accepting new patients
Lexington Counseling and Psychiatry, PLLC Mental Health Past Accepting new patients

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": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1659818037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404030802",
            "telephone_number": "859-985-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 GLADES RD STE 8",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031368",
            "telephone_number": "859-985-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAZAWA",
        "first_name": "JEANNE",
        "credential": "MA, LPCC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "246414",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "246414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100606150",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.