Carla Marie Suttles, M.ED, LPCC, LCADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

273150 Issued in KY

Practice address

30 Medpark Square Dr Ste 2
Somerset, KY 42503-1709

Phone

(833) 510-4357

Fax

(866) 460-2997

NPI assigned

Sep 13, 2019

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

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.

• Brightview, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Cincinnati, OH
  • NPI 1659769446
  NPD (past)

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1922658749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600",
            "telephone_number": "833-510-4357",
            "fax_number": "866-460-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDPARK SQUARE DR STE 2",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425031709",
            "telephone_number": "833-510-4357",
            "fax_number": "866-460-2997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "42501",
            "country_code": "US",
            "telephone_number": "066-872-0386",
            "fax_number": "606-200-3654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTTLES",
        "first_name": "CARLA",
        "middle_name": "MARIE",
        "credential": "M.ED, LPCC, LCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "268335",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "273150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100810360",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carlasuttleslpcc@icloud.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "90 Double C Acres Ln",
            "city": "Eubank",
            "state": "KY",
            "country_code": "US",
            "postal_code": "425678663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sunrise Manor Opco LLC
• Superior Indepedent Case Management
• Tina Marie Surber
• Susan J. Miller, PLLC
• Shauntay Sutherland, LPCA
• Glenna Ruth Sutton, LMFT
• Becky B Swann, RNBSN
• Janie Sweeney, PHYSICAL THERAPIST
• Emma Sylvester
• Joshua Wayne Tackett, CADCA

• Professional Counselor in Somerset, KY
• Providers in Somerset, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.