Individual provider Active NPI

Miran H. McClendon, LCADC, LPCC

  • Mental Health Counselor
  • Crittenden, KY
National Provider Identifier
1871982926
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
172295 Issued in KY
Practice address
405 Violet Rd
Crittenden, KY 41030-8956
Phone
(859) 301-5901
Fax
(859) 301-5940
NPI assigned
Jan 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 165248 KY
Mental Health Counselor 101YM0800X 172295 KY Primary

Addresses

Primary practice location

405 Violet Rd
Crittenden, KY 41030-8956

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 301-5901

Other identifiers 1

IdentifierTypeStateIssuer
7100504000MedicaidKY

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
I20240214002468 KY Practitioner - Mental Health Counselor 0941644223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

405 Violet Rd
Crittenden, KY 41030-8956
Phone (859) 428-1610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Mental Health CurrentSince Mar 29, 2024 Accepting new patients
Summit Medical Group, Inc. CurrentSince Mar 29, 2024 Accepting new patients
Prospering Counseling & Consulting LLC Addiction (Substance Use Disorder) CurrentSince Jan 1, 2024 Accepting new patients

Locations

351 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 572-2000

405 Violet Rd
Crittenden, KY 41030
Phone (859) 428-1610

100 Blackburn Ln
Dry Ridge, KY 41035
Phone (859) 823-5441

4122 Wahl Street Blvd
Ste 15
Louisville, KY 40218
Phone (502) 290-1288

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Organizations & group practices 12

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": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1871982926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-5901",
            "fax_number": "859-301-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 VIOLET RD",
            "city": "CRITTENDEN",
            "state": "KY",
            "postal_code": "410308956",
            "telephone_number": "859-301-5901",
            "fax_number": "859-301-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "MIRAN",
        "middle_name": "H.",
        "credential": "LCADC, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-13",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "165248",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "172295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100504000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crittenden, KY

Sources for this page

Verify at the official NPI Registry.