Individual provider Active NPI

Jodie R. Ellsworth, LPCC

  • Professional Counselor
  • Madisonville, KY
National Provider Identifier
1730714460
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
262220 Issued in KY
Practice address
1055 National Mine Dr
Madisonville, KY 42431-8913
Phone
(270) 821-8884
Fax
(270) 821-8885
NPI assigned
Mar 3, 2020
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 262220 KY Primary

Addresses

Primary practice location

1055 National Mine Dr
Madisonville, KY 42431-8913

Mailing address

203 N Elm St
Henderson, KY 42420-3132
Phone (270) 826-8761

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
I20240130001295 KY Practitioner - Mental Health Counselor 4789037409 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Current Accepting new patients
Lighthouse Counseling Services, Inc. CurrentSince Jun 28, 2025 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Jan 1, 2024 Accepting new patients
Lighthouse Counseling Services, Inc. CurrentSince Jun 28, 2025 Accepting new patients
Owensboro Health Medical Group, Inc. Professional CurrentSince Jan 1, 2024 Accepting new patients
Omni Community Health, Inc. Professional CurrentSince Jun 28, 2025 Accepting new patients

Locations

203 N Elm St
Henderson, KY 42420
Phone (270) 826-8761

1055 National Mine Dr
Madisonville, KY 42431
Phone (270) 821-8884

510 Ruby Dr
Madisonville, KY 42431
Phone (270) 399-7757

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

920 Frederica St
Ste 407
Owensboro, KY 42301
Phone (270) 684-1077

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": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1730714460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N ELM ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424203132",
            "telephone_number": "270-826-8761",
            "fax_number": "270-826-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 NATIONAL MINE DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424318913",
            "telephone_number": "270-821-8884",
            "fax_number": "270-821-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "JODIE",
        "middle_name": "R.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "262220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.