Individual provider Active NPI

Michele Rene Durkalski, LPCC

  • Mental Health Counselor
  • Glasgow, KY
National Provider Identifier
1710954425
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
104831 Issued in KY
Practice address
104 Reynolds Rd
Glasgow, KY 42141-1177
Phone
(270) 678-4801
Fax
(270) 678-3866
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 104831 KY Primary

Addresses

Primary practice location

104 Reynolds Rd
Glasgow, KY 42141-1177

Mailing address

104 Reynolds Rd
Glasgow, KY 42141-1177
Phone (270) 678-4801

Other practice location 1

1910 Lyda Ave
Bowling Green, KY 42104-3326
Phone (270) 904-6567

Other practice location 2

1600 Scottsville Rd Ste 101
Bowling Green, KY 42104-3217
Phone (270) 904-6567

Other identifiers 1

IdentifierTypeStateIssuer
7100728760MedicaidKY

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
I20240529001462 KY Practitioner - Mental Health Counselor 6305288820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Counseling AssociatesGroup PAC ID 9436443736, 11 clinicians

Practice addresses (Care Compare)

1910 Lyda Ave
Bowling Green, KY 42104-3326
Phone (270) 904-6567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Counseling Associates Mental Health CurrentSince May 5, 2024 Accepting new patients

Locations

1910 Lyda Ave
Bowling Green, KY 42104
Phone (270) 479-6904

1600 Scottsville Rd
Ste 101
Bowling Green, KY 42104
Phone (270) 781-0028

1830 Destiny Ln
Ste 110
Bowling Green, KY 42104
Phone (270) 846-3338

104 Reynolds Rd
Glasgow, KY 42141
Phone (270) 678-4801

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1710954425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 REYNOLDS RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411177",
            "telephone_number": "270-678-4801",
            "fax_number": "270-678-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 REYNOLDS RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411177",
            "telephone_number": "270-678-4801",
            "fax_number": "270-678-3866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1910 Lyda Ave",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421043326",
            "country_code": "US",
            "telephone_number": "270-904-6567",
            "fax_number": "270-904-6570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Scottsville Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421043217",
            "country_code": "US",
            "telephone_number": "270-904-6567",
            "fax_number": "270-904-6570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURKALSKI",
        "first_name": "MICHELE",
        "middle_name": "RENE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "104831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100728760",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.