Individual provider Active NPI

David J. Ralston, PHD, LCCC, ATC

  • Pastoral Counselor
  • Owensboro, KY
National Provider Identifier
1790714301
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
License
15038 Issued in KY
Practice address
319 W 10TH St
Suite 102
Owensboro, KY 42301-2900
Phone
(270) 316-6960
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0074 KY
Pastoral Counselor 101YP1600X 15038 KY Primary

Addresses

Primary practice location

319 W 10TH St
Suite 102
Owensboro, KY 42301-2900

Mailing address

319 W 10TH St
Suite 102
Owensboro, KY 42301-2900
Phone (270) 316-6960

Other identifiers 2

IdentifierTypeStateIssuer
00074OtherKYNATIONAL ATHLETIC TRAINERS ASSOCIATION
15038OtherNATIONAL CHRISTIAN COUNSELORS ASSOCIATION

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
15038KYMDPastoral Counselor
0074KYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Life Training Ministries, Inc. Pastoral Past Accepting new patients

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1790714301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 W 10TH ST",
            "address_2": "SUITE 102",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423012900",
            "telephone_number": "270-316-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 W 10TH ST",
            "address_2": "SUITE 102",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423012900",
            "telephone_number": "270-316-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALSTON",
        "first_name": "DAVID",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "PHD, LCCC, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "0074",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "KY",
            "license": "15038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL ATHLETIC TRAINERS ASSOCIATION",
            "identifier": "00074",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CHRISTIAN COUNSELORS ASSOCIATION",
            "identifier": "15038",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.