Kristi Miracle-Maynard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

257239 Issued in KY

Practice address

104 S Front Ave
Prestonsburg, KY 41653-1614

Phone

(606) 886-8572

Fax

(606) 886-4433

NPI assigned

May 14, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, OH2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Mountain Comprehensive Care Center, Inc.

  • Mental Health Counselor
  • Prestonsburg, KY
  • NPI 1760491674
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  KY, OH

  Medicare reassignment
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic Inez

  • Federally Qualified Health Center (FQHC)
  • Inez, KY
  • NPI 1285244244
  NPD
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic Mobile Unit

  • Federally Qualified Health Center (FQHC)
  • Paintsville, KY
  • NPI 1699386078
  NPD
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic Louisa

  • Federally Qualified Health Center (FQHC)
  • Louisa, KY
  • NPI 1114426863
  NPD (past)
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic for Children and Families

  • Federally Qualified Health Center (FQHC)
  • Pikeville, KY
  • NPI 1477136844
  NPD (past)
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic Grayson

  • Federally Qualified Health Center (FQHC)
  • Grayson, KY
  • NPI 1518441260
  NPD (past)
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic Winchester

  • Federally Qualified Health Center (FQHC)
  • Winchester, KY
  • NPI 1568102432
  NPD (past)
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic

  • Federally Qualified Health Center (FQHC)
  • Pikeville, KY
  • NPI 1730688359
  NPD (past)
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic Cynthiana

  • Federally Qualified Health Center (FQHC)
  • Cynthiana, KY
  • NPI 1770121972
  NPD (past)
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic Ashland

  • Federally Qualified Health Center (FQHC)
  • Ashland, KY
  • NPI 1801544861
  NPD (past)

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1891106613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRACLE-MAYNARD",
        "first_name": "KRISTI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "257239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Timothy Minix, DO
• Marcus S Minix Sr., OPTICIAN
• Melissa Minix
• Karen Minton
• Minuteman Medicine LLC
• Kristen Miracle
• Bryan Misura
• Austin Mitchell
• Chasity Mitchell
• Faith Mitchell

• Clinical Social Worker in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.