Jacqueline Richardson, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

268769 Issued in KY

Practice address

4010 Dupont Cir Ste 419
Louisville, KY 40207-4837

Phone

(502) 409-6993

Fax

(502) 409-6775

NPI assigned

Feb 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jacqueline Fleming Former name

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

Mental Health Counselor

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Meridian Behavioral Health IncGroup PAC ID 6709149321, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Meridian Behavioral Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Louisville, KY
  • NPI 1427569219
  Medicare reassignment Care Compare group NPD
• North Clark Medical Group LLC

  • General Practice Physician
  • Jeffersonville, IN
  • NPI 1376095711
  NPD (past)

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1992204465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 419",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074837",
            "telephone_number": "502-409-6993",
            "fax_number": "502-409-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 419",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074837",
            "telephone_number": "502-409-6993",
            "fax_number": "502-409-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JACQUELINE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "268769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "610661458",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "FLEMING",
            "credential": "LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher Matthew Richardson
• Erin Young Richardson, M.A.
• George Richardson
• Gina Richardson
• Hannah Marie Richardson, PSYD
• Juanita Richardson
• Juliana V Richardson, APRN
• Karly Richardson
• Kelly R Richardson, PA-C
• Kelty Richardson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.