| Heather Leann Jackson, LPCC | |
|
Simmons Elementary Healthy Kids Clinic, 830 Tyrone Pike, Versailles, KY 40383-1323 | |
| (844) 435-0900 | |
| (270) 858-4029 |
| Full Name | Heather Leann Jackson |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | Simmons Elementary Healthy Kids Clinic, Versailles, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679948491 | NPI | - | NPPES |
| 1679948491 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 283493 (Kentucky) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 169029 (Kentucky) | Secondary |
| Entity Name | Cumberland Family Medical Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306873500 PECOS PAC ID: 6305947789 Enrollment ID: O20120221000433 |
| Mailing Address | Practice Location Address |
|---|---|
| Heather Leann Jackson, LPCC Po Box 1080, Burkesville, KY 42717-1080 Ph: (270) 858-6655 | Heather Leann Jackson, LPCC Simmons Elementary Healthy Kids Clinic, 830 Tyrone Pike, Versailles, KY 40383-1323 Ph: (844) 435-0900 |
Mrs. Heather Godwin Kirkland, MS, LPCC-S, JSOCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4185 Lexington Rd, Versailles, KY 40383 Phone: 859-873-9277 | |
Christopher D Humphrey, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 830 Tyrone Pike, Versailles, KY 40383 Phone: 844-435-0900 Fax: 270-858-4029 | |
Miss Alyssa P. Vitali, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 460 Wilson Ave, Versailles, KY 40383 Phone: 859-753-6626 Fax: 859-787-0552 | |
Mrs. Veronica Jo Singleton, MA LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 220 Frankfort St Ste 1, Versailles, KY 40383 Phone: 859-753-7196 Fax: 859-214-4498 | |
Charlene Williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4185 Lexington Rd, Versailles, KY 40383 Phone: 859-873-9277 Fax: 859-873-9280 | |
Matthew Fowler, M.A. LPCC-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 220 Frankfort St Ste 1, Versailles, KY 40383 Phone: 859-753-7196 Fax: 859-214-4498 | |
Amber Kristin Hord-helme, MA LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 220 Frankfort St Ste 1, Versailles, KY 40383 Phone: 859-753-7196 Fax: 859-214-4498 |