| Bluegrass Behavioral Health & Consulting Services | |
|
601 Doe Run Dr Ste 5 Mt Sterling KY 40353-9097 | |
| (859) 432-3055 | |
| (859) 432-3044 |
| Full Name | Bluegrass Behavioral Health & Consulting Services |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 601 Doe Run Dr Ste 5, Mt Sterling, Kentucky |
| Authorized Official Name and Position | Shawnda Carter (CEO) |
| Authorized Official Contact | 8592746414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Behavioral Health & Consulting Services 601 Doe Run Dr Ste 5 Mt Sterling KY 40353-9097 Ph: (859) 432-3055 | Bluegrass Behavioral Health & Consulting Services 601 Doe Run Dr Ste 5 Mt Sterling KY 40353-9097 Ph: (859) 432-3055 |
| NPI Number | 1578234449 |
|---|---|
| Provider Enumeration Date | 09/21/2021 |
| Last Update Date | 08/13/2022 |
| Certification Date | 08/13/2022 |
| Medicare PECOS PAC ID | 7719359280 |
|---|---|
| Medicare Enrollment ID | O20230209000743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578234449 | NPI | - | NPPES |
| 7100806770 | Medicaid | KY |
| Provider Name | Shawnda Renee Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316512817 PECOS PAC ID: 5799157269 Enrollment ID: I20230209000924 |
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