Miran H Mcclendon, LCADC, LPCC | |
405 Violet Rd, Crittenden, KY 41030-8956 | |
(859) 301-5901 | |
(859) 301-5940 |
Full Name | Miran H Mcclendon |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 405 Violet Rd, Crittenden, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871982926 | NPI | - | NPPES |
7100504000 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 165248 (Kentucky) | Secondary |
101YM0800X | Counselor - Mental Health | 172295 (Kentucky) | Primary |
Entity Name | Summit Medical Group, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508287640 PECOS PAC ID: 2163326240 Enrollment ID: O20031120000738 |
Entity Name | Mhjm Counseling Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477259117 PECOS PAC ID: 4688018963 Enrollment ID: O20240214002156 |
Mailing Address | Practice Location Address |
---|---|
Miran H Mcclendon, LCADC, LPCC Po Box 635283, Cincinnati, OH 45263-5283 Ph: (859) 301-5901 | Miran H Mcclendon, LCADC, LPCC 405 Violet Rd, Crittenden, KY 41030-8956 Ph: (859) 301-5901 |
Mary Milner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 520 Violet Rd, Crittenden, KY 41030 Phone: 859-428-4100 | |
Connie Kiser, LPCA Counselor Medicare: Medicare Enrolled Practice Location: 520 Violet Road, Crittenden, KY 41030 Phone: 859-428-4100 Fax: 859-428-2134 | |
Christine Hearth, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 520 Violet Rd, Crittenden, KY 41030 Phone: 859-428-4100 |