Individual provider Active NPI

Kendra Renee Gross, M.ED, LPCC

  • Mental Health Counselor
  • Richmond, KY
National Provider Identifier
1992259402
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
269446 Issued in KY
Practice address
451 Big Hill Ave Ste 5
Richmond, KY 40475
Phone
(859) 482-7862
Fax
(859) 999-7869
NPI assigned
Aug 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 168628 KY
Mental Health Counselor 101YM0800X 168628 KY
Professional Counselor 101YP2500X 269446 KY
Mental Health Counselor 101YM0800X 269446 KY Primary

Addresses

Primary practice location

451 Big Hill Ave Ste 5
Richmond, KY 40475

Mailing address

PO Box 802
Berea, KY 40403-0802
Phone (859) 428-7862

Other practice location 1

292 Glades Rd Ste 8
Berea, KY 40403-1368
Phone (859) 428-7862

Other identifiers 1

IdentifierTypeStateIssuer
7100728130MedicaidKY

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
168628KYMDMental Health Counselor
269446KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Reflections Therapeutic Services, LLC Current Accepting new patients
Parsons Counseling, LLC Counselor PastSince Apr 15, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1992259402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404030802",
            "telephone_number": "859-428-7862",
            "fax_number": "859-999-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 BIG HILL AVE STE 5",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "40475",
            "telephone_number": "859-482-7862",
            "fax_number": "859-999-7869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "292 Glades Rd Ste 8",
            "address_purpose": "LOCATION",
            "city": "Berea",
            "state": "KY",
            "postal_code": "404031368",
            "country_code": "US",
            "telephone_number": "859-428-7862",
            "fax_number": "859-999-7869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "KENDRA",
        "middle_name": "RENEE",
        "credential": "M.ED, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KY",
            "license": "168628",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "168628",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "269446",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "269446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100728130",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.