Melanie Lynn Staderman, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

KY-08-030 Issued in KY

Practice address

928 Old Elizabethtown Rd
Suite 7
Hodgenville, KY 42748-9413

Phone

(270) 723-1220

NPI assigned

Dec 2, 2013

Last updated

Dec 2, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inside Out, LLC

  • Community/Behavioral Health Agency
  • Hodgenville, KY
  • NPI 1699221523
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1942631866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 OLD ELIZABETHTOWN RD",
            "address_2": "SUITE 7",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "427489413",
            "telephone_number": "270-723-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 OLD ELIZABETHTOWN RD",
            "address_2": "SUITE 7",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "427489413",
            "telephone_number": "270-723-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADERMAN",
        "first_name": "MELANIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "KY-08-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Nicole Sheffield, LCSW
• Doddachallor Matt Shivakumar, M.D.,
• Shopko Stores Operating Co LLC (Shopko Pharmacy 730)
• Smith Drug Co, Inc
• Rebecca Grace Smith, LCSW
• Steven Preston MD PLLC
• Li Tan, PHARMD
• Timeless Skin Studio, LLC
• Khue N Tran, MD
• W I N G S Professional Consulting

• Marriage & Family Therapist in Hodgenville, KY
• Providers in Hodgenville, KY by specialty
• Marriage & Family Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.