Individual provider Active NPI

Kelsey D Leveridge

  • Professional Counselor
  • Hazard, KY
National Provider Identifier
1679224257
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
277285 Issued in KY
Practice address
101 Town and Country LN Ste 106
Hazard, KY 41701-9524
Phone
(606) 435-7557
Fax
(606) 435-7558
NPI assigned
Jan 14, 2022
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 260760 KY
Mental Health Counselor 101YM0800X 277285 KY
Professional Counselor 101YP2500X 277285 KY Primary

Addresses

Primary practice location

101 Town and Country LN Ste 106
Hazard, KY 41701-9524

Mailing address

PO Box 2011
Hazard, KY 41702-2011
Phone (606) 435-7557

Other identifiers 1

IdentifierTypeStateIssuer
7100815470MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260129000138 KY Practitioner - Mental Health Counselor 9436687456 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Primary Care Centers of Eastern Kentucky LLCGroup PAC ID 3971415993, shared by 5 NPIs, 46 clinicians
Beacons of Hope LLCGroup PAC ID 6709255821, 2 clinicians

Practice addresses (Care Compare)

10616 S Ky Hwy 15
Suite a
Scuddy, KY 41760-9031
Phone (606) 476-2274

194 Boh Lane
Hazard, KY 41701-9524
Phone (606) 551-1140

425 Hindman Byp
Hindman, KY 41822-8666
Phone (606) 785-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
260760KYMDCounselor
277285KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Centers of Eastern Kentucky, LLC Current Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC Current Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC CurrentSince Oct 1, 2025 Accepting new patients
Beacons of Hope, LLC CurrentSince Dec 23, 2024 Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC CurrentSince Oct 1, 2025 Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC Current Accepting new patients

Locations

101 Town and Country Ln
#100
Hazard, KY 41701
Phone (606) 439-1300

101 Town and Country Ln
Ste 106
Hazard, KY 41701
Phone (606) 435-7536

425 Hindman Byp
Hindman, KY 41822
Phone (606) 785-1300

21992 Main St
Hyden, KY 41749
Phone (606) 672-5200

47 Highway 119 S
Ste 3
Whitesburg, KY 41858
Phone (606) 403-0001

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCJFBA

Organizations & group practices 6

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": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1679224257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2011",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417022011",
            "telephone_number": "606-435-7557",
            "fax_number": "606-435-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TOWN AND COUNTRY LN STE 106",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019524",
            "telephone_number": "606-435-7557",
            "fax_number": "606-435-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERIDGE",
        "first_name": "KELSEY",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KY",
            "license": "260760",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "277285",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "277285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100815470",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.