Active NPI
Kennedy Brooke Conley
- Addiction (Substance Use Disorder) Counselor
- Louisa, KY
National Provider Identifier
1770231318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 125 S Main Cross St
Louisa, KY 41230-1065 - Phone
- (606) 638-0938
- NPI assigned
- Mar 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
125 S Main Cross St
Louisa, KY 41230-1065
Mailing address
37 W Main St
Buckhannon, WV 26201-2235
Phone (302) 473-5600
Other practice location 1
34 N Kanawha St
Buckhannon, WV 26201-2714
Phone (304) 924-6262
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674172800000",
"number": "1770231318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 W MAIN ST",
"city": "BUCKHANNON",
"state": "WV",
"postal_code": "262012235",
"telephone_number": "302-473-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 S MAIN CROSS ST",
"city": "LOUISA",
"state": "KY",
"postal_code": "412301065",
"telephone_number": "606-638-0938"
}
],
"practiceLocations": [
{
"address_1": "34 N Kanawha St",
"address_purpose": "LOCATION",
"city": "Buckhannon",
"state": "WV",
"postal_code": "262012714",
"country_code": "US",
"telephone_number": "304-924-6262",
"fax_number": "304-924-6699",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONLEY",
"first_name": "KENNEDY",
"middle_name": "BROOKE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-14",
"last_updated": "2023-01-20",
"certification_date": "2023-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Louisa, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.