Active NPI
Angelyn Medley, LPCC
- Professional Counselor
- Grayson, KY
National Provider Identifier
1942749171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 266703
- Practice address
- 840 Interstate Dr
Grayson, KY 41143-1768 - Phone
- (606) 329-8588
- Fax
- (606) 329-8195
- NPI assigned
- Feb 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 240248 | KY | |
| Professional Counselor | 101YP2500X | 266703 | KY | Primary |
Addresses
Primary practice location
840 Interstate Dr
Grayson, KY 41143-1768
Mailing address
PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
840 Interstate Dr
Grayson, KY 41143-1768
Phone (606) 474-5151
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240248 | KY | MD | Counselor |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ashland, KY
- NPI 1982615043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721174400000",
"number": "1942749171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 790",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411050790",
"telephone_number": "606-329-8588",
"fax_number": "606-329-8195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 INTERSTATE DR",
"city": "GRAYSON",
"state": "KY",
"postal_code": "411431768",
"telephone_number": "606-329-8588",
"fax_number": "606-329-8195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDLEY",
"first_name": "ANGELYN",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-21",
"last_updated": "2024-07-17",
"certification_date": "2024-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "KY",
"license": "240248",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "266703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grayson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.