Kenneth Jay Zumbaugh, MS, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39000953A Issued in IN

Practice address

655 E Main St
Peru, IN 46970-2662

Phone

(765) 472-1931

Fax

(765) 472-1945

NPI assigned

Jun 29, 2006

Last updated

Apr 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Four County Comprehensive Mental Health Center IncGroup PAC ID 2163334277, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Four County Comprehensive Mental Health Center Inc

  dba 4C Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Peru, IN
  • NPI 1972545945
  Medicare reassignment Care Compare group NPD
• Four County Comprehensive Mental Health Center, Inc

  dba 4C Health

  • Psychiatric Hospital
  • Peru, IN
  • NPI 1457539751
  NPD

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1801824842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471526",
            "telephone_number": "574-722-5151",
            "fax_number": "574-739-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E MAIN ST",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469702662",
            "telephone_number": "765-472-1931",
            "fax_number": "765-472-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUMBAUGH",
        "first_name": "KENNETH",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "MS, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IN",
            "license": "39000953A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000953A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "00000185891",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zoe Wolfe
• In T Yoon, M.D.
• Young Mens Christian Association
• David Phillip Zandi, DDS
• Jennifer Nichole Zell, BA

• Mental Health Counselor in Peru, IN
• Providers in Peru, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.