Active NPI
Shaun E Caudill, KLPC
- Pastoral Counselor
- Elizabethtown, KY
National Provider Identifier
1922862085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 260687
- Practice address
- 312 N. Mulberry St.
Suite 105
Elizabethtown, KY 42701 - Phone
- (270) 449-1643
- NPI assigned
- Feb 9, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 260687 | KY | Primary |
Addresses
Primary practice location
312 N. Mulberry St.
Suite 105
Elizabethtown, KY 42701
Mailing address
48 Reva Ridge Rd.
Elizabethtown, KY 42701
Phone (270) 789-8696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 260687 | KY | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1922862085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 REVA RIDGE RD.",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "42701",
"telephone_number": "270-789-8696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 N. MULBERRY ST.",
"address_2": "SUITE 105",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "42701",
"telephone_number": "270-449-1643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAUDILL",
"first_name": "SHAUN",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "KLPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-09",
"last_updated": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "KY",
"license": "260687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.