Prodigal Ministries, LLC
Counselor, Mental Health in Buckner, KY. Organization (NPI-2).
NPI number1013662717
StatusActive
Last updated in NPPESDec 12, 2023
Details
- NPI
- 1013662717
- Entity type
- Organization (NPI-2)
- Legal business name
- Prodigal Ministries, LLC
- Organization subpart
- No
- Enumeration date
- Feb 21, 2022
- Certification date
- Dec 12, 2023
- Last updated
- Dec 12, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 324500000X | Substance Abuse Rehabilitation Facility | – | – |
Other names
- Prodigal Ministries (Doing Business As)
- Prodigal Counseling Services (Doing Business As)
Practice location
4414 Old Lagrange RdBuckner, KY 40010-9547
Phone 502-222-2389
Mailing address
Po Box 1484Crestwood, KY 40014-1484
Other practice locations
121 W Oak St
Louisville, KY 40203-2813
Louisville, KY 40203-2813
Phone 502-222-2389
6501 W Highway 22
Crestwood, KY 40014-9317
Crestwood, KY 40014-9317
Phone 502-222-2389
256 Main St Ste B
Florence, KY 41042-2050
Florence, KY 41042-2050
Phone 502-222-2389
Authorized official
Nina J Roy
Reconciliation Director
2705854306
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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