| Mr Kevin Lucas Ledford, MS, NCC, LADAC II | |
|
37 Sandstone Cir Ste 92, Jackson, TN 38305-3168 | |
| (731) 265-6025 | |
| Not Available |
| Full Name | Mr Kevin Lucas Ledford |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 37 Sandstone Cir Ste 92, Jackson, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780405779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1713 (Tennessee) | Primary |
| Entity Name | Impact Behavioral Counseling Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386169050 PECOS PAC ID: 1355604836 Enrollment ID: O20190404001313 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Kevin Lucas Ledford, MS, NCC, LADAC II 821 Merrywood Gln Apt 3, Memphis, TN 38117-5065 Ph: (901) 486-1155 | Mr Kevin Lucas Ledford, MS, NCC, LADAC II 37 Sandstone Cir Ste 92, Jackson, TN 38305-3168 Ph: (731) 265-6025 |
Tony Hatley, LPC/MHSP Counselor Medicare: Not Enrolled in Medicare Practice Location: 26 Lamar Cir, Jackson, TN 38305 Phone: 731-220-2919 | |
Doris Kay Black, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 39 Murray Guard Dr, Jackson, TN 38305 Phone: 731-736-4400 | |
Mrs. Robyn Elizabeth Mcdaniel, LPC/MHSP (TEMP), NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 384 Carriage House Dr Ste C, Jackson, TN 38305 Phone: 731-868-7297 | |
Sonya Taylor, Counselor Medicare: Not Enrolled in Medicare Practice Location: 24 Weatherford Sq, Jackson, TN 38305 Phone: 731-660-6760 Fax: 731-661-9152 | |
Mrs. Linda Sue Hottenstein, M.ED,LPC/MHSP,RPT-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 386 Carriage House Dr Ste A, Jackson, TN 38305 Phone: 731-664-0043 Fax: 731-664-0172 | |
Dr. Samuel Lee Carney, PHD Counselor Medicare: Not Enrolled in Medicare Practice Location: 37 Executive Dr, Jackson, TN 38305 Phone: 731-426-1820 Fax: 731-426-0675 | |
Justin Edward Crowder, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 60 Lynoak Cv, Suite C, Jackson, TN 38305 Phone: 731-668-7593 Fax: 731-660-7512 |