Jeffrey Combs, LPCC

Individual provider Active NPI Professional Counselor · Leburn, KY

NPI 1689173825 · NPPES record last updated Jun 30, 2023

Key facts

NPI
1689173825
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
175315 (KY)
Practice address
25 Clydean Dr
Leburn, KY 41831-8702
Phone
(606) 785-1148
NPI assigned
Feb 2, 2018
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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 IDStateProvider typePAC IDDetails
I20240423001318 KY Practitioner - Mental Health Counselor 1658719091 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Blossom Services, PLLC Mental Health Current
since Mar 8, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 175315 KY Yes

Addresses

Primary practice location

25 Clydean Dr
Leburn, KY 41831-8702

Mailing address

1192 Pigeonroost Rd
Bulan, KY 41722-9027
Phone (606) 216-5431

Other practice location 1

1192 Pigeonroost Rd
Bulan, KY 41722-9027
Phone (606) 216-5431

Other providers in Leburn, KY

All providers in Leburn, KY · Professional Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.