Kevin Lucas Ledford, MS, NCC, LADAC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1713 Issued in TN

Practice address

37 Sandstone Cir Ste 92
Jackson, TN 38305-3168

Phone

(731) 265-6025

NPI assigned

Oct 22, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Impact Behavioral Counseling LLC 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Impact Behavioral Counseling LLC

  • Addiction (Substance Use Disorder) Counselor
  • Jackson, TN
  • NPI 1386169050

  Addiction (Substance Use Disorder), TN

  Medicare reassignment Care Compare group NPD
• Impact Healthcare, PLLC

  • Addiction Medicine (Family Medicine) Physician
  • Jackson, TN
  • NPI 1487185153
  NPD (past)

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1780405779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 MERRYWOOD GLN APT 3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381175065",
            "telephone_number": "901-486-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 SANDSTONE CIR STE 92",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053168",
            "telephone_number": "731-265-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDFORD",
        "first_name": "KEVIN",
        "middle_name": "LUCAS",
        "name_prefix": "Mr.",
        "credential": "MS, NCC, LADAC II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "1713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany J Lawrence, MD
• Peter G Lawrence, M.D.
• Stephanie Phillips Layman, OD
• Leann Care LLC
• Learning Achievement Center
• Maricharles Ledsinger, M.S.
• Erica D Lee
• Gina Kim Lee, OTR
• Joon Young Lee, MD
• Kristen Goehring Lee

• All providers in Jackson, TN
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.