Nicholas Wayne Bloodworth, LMFT
Individual provider Active NPI Marriage & Family Therapist · Columbia, KY
NPI 1669869327 · NPPES record last updated Apr 18, 2018
Key facts
- NPI
- 1669869327
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 240324 (KY)
- Practice address
- 441 E 80 Dr
Columbia, KY 42728-8927 - Phone
- (270) 250-5264
- NPI assigned
- Apr 21, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Somerset Mental Health, PSC
Practice addresses (Care Compare)
149 Enterprise Dr
Somerset, KY 42501-6155
Phone (606) 679-6995
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 |
|---|---|---|---|---|
| I20240729001552 | KY | Practitioner - Marriage and Family Therapist | 3678019403 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Somerset Mental Health, PSC | Current |
Accepting new patients |
Locations
149 Enterprise Dr
Somerset, KY 42501
Phone (606) 679-6995
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 240324 | KY | Yes |
Addresses
Primary practice location
441 E 80 Dr
Columbia, KY 42728-8927
Mailing address
441 E 80 Dr
Columbia, KY 42728-8927
Phone (270) 250-5264
Other providers in Columbia, KY
- Beyond the Label LLC
- Beyond the Label LLC
- Chasity Biggerstaff
- Jodie Lynn Bivens
- Jennifer R Blair
- Kayla Bodner
- Kendra R Bolom
- David Earl Bowman
- Callie Jo Bradford
- Leticia Nichole Branham
All providers in Columbia, KY · Marriage & Family Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2018. 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.