| Bluegrass Counseling & Trauma Services | |
|
503 Darby Creek Rd Ste C Lexington KY 40509-1603 | |
| (859) 368-2567 | |
| (859) 788-3905 |
| Full Name | Bluegrass Counseling & Trauma Services |
|---|---|
| Speciality | Counselor |
| Location | 503 Darby Creek Rd Ste C, Lexington, Kentucky |
| Authorized Official Name and Position | Crystal Stapleton (CONTRACTING DIRECTOR) |
| Authorized Official Contact | 2703801093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Counseling & Trauma Services 503 Darby Creek Rd Ste C Lexington KY 40509-1603 Ph: (859) 368-2567 | Bluegrass Counseling & Trauma Services 503 Darby Creek Rd Ste C Lexington KY 40509-1603 Ph: (859) 368-2567 |
| NPI Number | 1366197147 |
|---|---|
| Provider Enumeration Date | 02/19/2022 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Medicare PECOS PAC ID | 0042693137 |
|---|---|
| Medicare Enrollment ID | O20220823001966 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366197147 | NPI | - | NPPES |
| 7100808560 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jackie Stethem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740848324 PECOS PAC ID: 2062844905 Enrollment ID: I20191115000215 |
| Provider Name | Rebecca Bruner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558938654 PECOS PAC ID: 2567857048 Enrollment ID: I20220318002324 |
| Provider Name | Treven John Back |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518646967 PECOS PAC ID: 7719331776 Enrollment ID: I20230925001055 |
| Provider Name | Leila M Goodpaster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467964486 PECOS PAC ID: 3577946664 Enrollment ID: I20240319004109 |
| Provider Name | Steven Duff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386128676 PECOS PAC ID: 9133567134 Enrollment ID: I20240410001566 |
| Provider Name | Erin Paige Greenlee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255030516 PECOS PAC ID: 0547700494 Enrollment ID: I20240906001955 |
| Provider Name | Helena Bergman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245938935 PECOS PAC ID: 6406378835 Enrollment ID: I20250314002428 |
Alexander J. Tikhtman, M.d., P.s.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1517 Nicholasville Rd, Suite 403, Lexington, KY 40503 Phone: 859-276-6168 Fax: 859-276-0850 | |
Verbal Behavior Consulting, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1035 Strader Dr Ste 150, Lexington, KY 40505 Phone: 859-899-9200 Fax: 859-899-9202 | |
Thomas-peeples & Associates, Psc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Dennis Dr, Lexington, KY 40503 Phone: 859-278-4775 Fax: 859-373-0018 | |
Kvc Behavorial Healthcare Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Beasley St, Lexington, KY 40509 Phone: 859-254-1035 | |
Momo Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 162 Glenn Pl, Lexington, KY 40505 Phone: 502-509-9436 | |
Andre N. Fernandez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Darby Creek Rd, Suite 21, Lexington, KY 40509 Phone: 859-263-9305 Fax: 859-264-1169 | |
Mended Counseling & Trauma Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 824 Euclid Ave Ste A102, Lexington, KY 40502 Phone: 859-338-0006 |