Individual provider Active NPI

Virginia Stambaugh, LPCC

  • Mental Health Counselor
  • Prestonsburg, KY
National Provider Identifier
1922419530
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
247385 Issued in KY
Practice address
104 S Front Ave
Prestonsburg, KY 41653
Phone
(606) 886-8572
Fax
(606) 886-4433
NPI assigned
May 16, 2014
Last updated
Dec 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 247385 KY Primary

Addresses

Primary practice location

104 S Front Ave
Prestonsburg, KY 41653

Mailing address

104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572

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
I20240102003752 KY Practitioner - Mental Health Counselor 8628428620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1110 S Mayo TRL
Paintsville, KY 41240-1273
Phone (606) 788-1345

341 Court St
Paintsville, KY 41240-1051
Phone (606) 789-4675

838 S Mayo TRL
Paintsville, KY 41240-1384
Phone (606) 788-1345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
247385KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Comprehensive Care Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Mountain Comprehensive Care Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Mountain Comprehensive Care Center, Inc. Mental Health Current Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients

Locations

1110 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345

1110 S Mayo Trl
#A
Paintsville, KY 41240
Phone (606) 788-1345

1110 S Mayo Trl
Ste B
Paintsville, KY 41240

838 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345

104 S Front Ave
Prestonsburg, KY 41653
Phone (606) 688-6857

Organizations & group practices 8

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": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1922419530",
    "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": "41653",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMBAUGH",
        "first_name": "VIRGINIA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "247385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prestonsburg, KY

Sources for this page

Verify at the official NPI Registry.