| Four Rivers Behavioral Health | |
|
425 Broadway Suite 201 Paducah KY 42001 | |
| (270) 442-7121 | |
| (270) 443-9692 |
| Full Name | Four Rivers Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 425 Broadway, Paducah, Kentucky |
| Authorized Official Name and Position | Terry E. Hudspeth (PRESIDENT/CEO) |
| Authorized Official Contact | 2704421452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Rivers Behavioral Health 425 Broadway Suite 201 Paducah KY 42001 Ph: (270) 442-7121 | Four Rivers Behavioral Health 425 Broadway Suite 201 Paducah KY 42001 Ph: (270) 442-7121 |
| NPI Number | 1841216934 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 04/06/2023 |
| Certification Date | 04/06/2023 |
| Medicare PECOS PAC ID | 0446154587 |
|---|---|
| Medicare Enrollment ID | O20031121000001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841216934 | NPI | - | NPPES |
| 000000057108 | Other | KY | ANTHEM BCBS |
| 27001015 | Medicaid | KY | |
| 30601017 | Medicaid | KY | |
| 29100946 | Medicaid | KY | |
| 33900242 | Medicaid | KY | |
| 28001014 | Medicaid | KY | |
| 29100948 | Medicaid | KY | |
| 000000057108 | Other | ANTHEM BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 800001 (Kentucky) | Primary |
| Provider Name | Leah E Fondaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245558097 PECOS PAC ID: 3072644038 Enrollment ID: I20100708000607 |
| Provider Name | Gretchen A Roof |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700949849 PECOS PAC ID: 2062609860 Enrollment ID: I20101206000929 |
| Provider Name | Duncan E Darnell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003809997 PECOS PAC ID: 4880867084 Enrollment ID: I20111103000772 |
| Provider Name | Leta M Whited |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881723732 PECOS PAC ID: 9931242294 Enrollment ID: I20120507000340 |
| Provider Name | Samantha D Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982950432 PECOS PAC ID: 2264689884 Enrollment ID: I20120904000140 |
| Provider Name | Pamela G Owen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386956373 PECOS PAC ID: 8921237074 Enrollment ID: I20140212001131 |
| Provider Name | Fumiko Hattori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396154480 PECOS PAC ID: 2466671367 Enrollment ID: I20140908001706 |
| Provider Name | Craig D Keene |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144371758 PECOS PAC ID: 6204055908 Enrollment ID: I20140911000697 |
| Provider Name | Sondra A Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063576064 PECOS PAC ID: 5496069890 Enrollment ID: I20150729008968 |
| Provider Name | Elizabeth A Fleming |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457415416 PECOS PAC ID: 6901110790 Enrollment ID: I20150807013482 |
| Provider Name | Edd Easton-hogg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376877498 PECOS PAC ID: 3870895535 Enrollment ID: I20160112002371 |
| Provider Name | Scott Helm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255535654 PECOS PAC ID: 2668509639 Enrollment ID: I20171027002629 |
| Provider Name | Kala Chakradhar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225443229 PECOS PAC ID: 6305182999 Enrollment ID: I20190118002033 |
| Provider Name | Devin Michael Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073076071 PECOS PAC ID: 9133461783 Enrollment ID: I20190430002358 |
| Provider Name | Jerri Lynn Dunn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750405825 PECOS PAC ID: 8123342748 Enrollment ID: I20200923001362 |
| Provider Name | Erin D Northington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710226170 PECOS PAC ID: 1355759176 Enrollment ID: I20210415002876 |
| Provider Name | Hannah K Klein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033542311 PECOS PAC ID: 7012325764 Enrollment ID: I20210416001561 |
| Provider Name | Michelle D Shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912582438 PECOS PAC ID: 6002218369 Enrollment ID: I20210708002036 |
| Provider Name | Marilee Bayne Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548856388 PECOS PAC ID: 3971906348 Enrollment ID: I20210722001005 |
| Provider Name | Derek William Ratliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861094211 PECOS PAC ID: 7416353396 Enrollment ID: I20210831003191 |
| Provider Name | Karen A Graham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679636757 PECOS PAC ID: 1355748799 Enrollment ID: I20210927003380 |
| Provider Name | Laneir Charlaine Sprague |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629515523 PECOS PAC ID: 2062819444 Enrollment ID: I20210928001692 |
| Provider Name | Brenden Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457986093 PECOS PAC ID: 4880068386 Enrollment ID: I20230324000472 |
| Provider Name | Sara R Black |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831653369 PECOS PAC ID: 9335590199 Enrollment ID: I20240105003660 |
| Provider Name | Lora Wright |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154831196 PECOS PAC ID: 2769833524 Enrollment ID: I20240105003761 |
| Provider Name | Janice Schofield |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437225240 PECOS PAC ID: 7416308853 Enrollment ID: I20240110000563 |
| Provider Name | Matthew Sloan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629371786 PECOS PAC ID: 7911358304 Enrollment ID: I20240110002387 |
| Provider Name | Courtney Ledgerwood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134631955 PECOS PAC ID: 3577915925 Enrollment ID: I20240122001594 |
| Provider Name | Simon Crouch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639653918 PECOS PAC ID: 1355793712 Enrollment ID: I20240122001800 |
| Provider Name | Christine Black |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184026528 PECOS PAC ID: 6002269248 Enrollment ID: I20240124002480 |
| Provider Name | Sharon Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225550445 PECOS PAC ID: 9133572290 Enrollment ID: I20240125001846 |
| Provider Name | Susan Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881082550 PECOS PAC ID: 3173976925 Enrollment ID: I20240127000661 |
| Provider Name | Amanda L Mcintosh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861815805 PECOS PAC ID: 4587017397 Enrollment ID: I20240129001844 |
| Provider Name | Kridtian Alton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528318516 PECOS PAC ID: 3779936505 Enrollment ID: I20240129002558 |
| Provider Name | Melanie Pack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386022119 PECOS PAC ID: 1153630488 Enrollment ID: I20240206002857 |
| Provider Name | Jennifer Frey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790236248 PECOS PAC ID: 9335582881 Enrollment ID: I20240212003989 |
| Provider Name | Sarah Elizabeth Trover |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184042673 PECOS PAC ID: 6709222193 Enrollment ID: I20240307002251 |
| Provider Name | Lisa Kay Fletcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548765332 PECOS PAC ID: 9234596990 Enrollment ID: I20240307003013 |
| Provider Name | John Haase |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326547092 PECOS PAC ID: 8820434152 Enrollment ID: I20240308003512 |
| Provider Name | Christina D Sams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346684107 PECOS PAC ID: 8820434806 Enrollment ID: I20240313000464 |
Summit Mental Wellness And Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4630 Village Square Dr, Suite 202, Paducah, KY 42001 Phone: 270-777-4490 Fax: 866-824-4022 | |
Laurie K. Ballew Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 657 Lone Oak Rd Ste 2, Paducah, KY 42003 Phone: 270-558-4174 Fax: 270-534-5753 | |
Psychological Associates Of Paducah, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2315 Broadway St, Paducah, KY 42001 Phone: 270-442-8785 Fax: 270-443-1784 | |
Millstone Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4001 Hansen Rd, Paducah, KY 42001 Phone: 270-554-9216 Fax: 270-554-8732 | |
Integrated Psychological Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 413 Broadway St Unit A, Paducah, KY 42001 Phone: 618-727-1913 | |
Purchase Neurology Psc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 Medical Center Drive, Suite 402, Paducah, KY 42003 Phone: 270-441-4400 Fax: 270-441-4409 | |
Crossroads Treatment Centers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 327 Coleman Rd, Paducah, KY 42001 Phone: 800-805-6989 |