NPIMap

Organization Active NPI

KCC Recovery, LLC Dba Bluegrass Recovery, LLC

  • Professional Counselor
  • Louisville, KY
National Provider Identifier
1699261529
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
KCC RECOVERY, LLC DBA BLUEGRASS RECOVERY, LLC
Practice address
1169 Eastern Pkwy Ste 3310
Louisville, KY 40217-1415
Phone
(502) 443-5273
Fax
(502) 333-9180
NPI assigned
Jul 3, 2018
Last updated
Jun 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Laronica Lawson, MBANPI 1922625649
Title
Ceo
Phone
(502) 483-1862

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary
Nurse Practitioner 363L00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

1169 Eastern Pkwy Ste 3310
Louisville, KY 40217-1415

Mailing address

17127 Piton Way
Louisville, KY 40245-5409
Phone (502) 483-1862

Other identifiers 1

IdentifierTypeStateIssuer
7100342240MedicaidKY

National Provider Directory

National Provider Directory

Locations

4835 Poplar Level Rd
Ste 110
Louisville, KY 40213
Phone (502) 443-5273

Practitioners & affiliated clinicians

Practitioners 49

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.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1699261529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17127 PITON WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455409",
            "telephone_number": "502-483-1862",
            "fax_number": "502-333-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY STE 3310",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171415",
            "telephone_number": "502-443-5273",
            "fax_number": "502-333-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCC RECOVERY, LLC DBA BLUEGRASS RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-03",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "LARONICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-483-1862",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100342240",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.