Individual provider Active NPI

Jennifer Frey, LPCA

  • Professional Counselor
  • Paducah, KY
National Provider Identifier
1790236248
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
282524 Issued in KY
Practice address
425 Broadway St
Paducah, KY 42001-0713
Phone
(270) 442-9767
NPI assigned
Oct 19, 2016
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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 282524 KY Primary

Addresses

Primary practice location

425 Broadway St
Paducah, KY 42001-0713

Mailing address

6100 Majestic Oak Dr
Paducah, KY 42003-8814
Phone (270) 556-7683

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
I20240212003989 KY Practitioner - Mental Health Counselor 9335582881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Ky Regional MHMR Board IncGroup PAC ID 0446154587, 31 clinicians

Practice addresses (Care Compare)

425 Broadway St
Suite 102
Paducah, KY 42001-0713
Phone (270) 442-1452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Western Ky Regional MHMR Board Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

425 Broadway St
Paducah, KY 42001
Phone (270) 442-1452

425 Broadway St
#201
Paducah, KY 42001
Phone (270) 442-1452

425 Broadway St
Ste 102
Paducah, KY 42001
Phone (270) 442-1452

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, 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": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1790236248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 MAJESTIC OAK DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420038814",
            "telephone_number": "270-556-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420010713",
            "telephone_number": "270-442-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREY",
        "first_name": "JENNIFER",
        "credential": "LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "282524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.