BLUEGRASS BEHAVIORAL HEALTH GROUP (NPI# 1952840860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952840860 |
| Entity Type | Organization |
| Organization Name | BLUEGRASS BEHAVIORAL HEALTH GROUP |
| Other Organization Name | CULTIVATE BEHAVIORAL HEALTH AND EDUCATION |
| Practice Address |
925 Dudley Pike Edgewood KY 41017-8120 |
| Mailing Address |
12600 Hill Country Blvd Ste R-100 Bee Cave TX 78738-6748 |
| Practice Telephone | 8593603006 |
| Practice Fax Number | 8593603053 |
| Mailing Telephone | 5127724042 |
| Mailing Fax Number | 5128427446 |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2020-10-04 |
| Authorized Official Name | CANDACE WEBB (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 5127724042 |
| Is Organization Subpart | Y |
| Parent Organization Name | CULTIVATE BEHAVIORAL MANAGEMENT CORP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100446170 | 05 |
| Other Name | Type Code |
|---|---|
| Cultivate Behavioral Health and Education | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 105 Windsor Path Ste 1, Georgetown, KY 403249819 | 8595596041 | |
| 112 Dennis Dr, Lexington, KY 405032988 | 8595596044 | |
| 1230 Liberty Bank Ln Ste And240, Louisville, KY 402225756 | 8593603006 | 8593603053 |
| 1374 Highway 192 E, London, KY 407413123 | 8593603006 | 8593603053 |
| 205 E Mount Vernon St, Somerset, KY 425011412 | 8593603006 | 8593603053 |
| 219 Daniel Boone Dr, Barbourville, KY 409061167 | 8593603006 | 8593603053 |
| 334 Beechwood Rd # 502, Ft Mitchell, KY 410171611 | 8593603006 | |
| 350 Corporate Way Ste 400, Orange Park, FL 320732853 | 9043859241 | |
| 6211 Windward Ct, Fleming Island, FL 320038011 | 9043859241 |
| Street Address |
925 DUDLEY PIKE |
| City | EDGEWOOD |
| State | KY |
| Zip Code | 41017-8120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154946929 | Stephanie Walker | Behavioral Analyst | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2020-06-08 |
| 1699398677 | Cameron Meador | Counselor | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2020-05-25 |
| 1376164269 | Roxana Shohreh Kennedy | Marriage & Family Therapist | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2020-05-01 |
| 1477187219 | Ian Aiuto | Social Worker | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2020-03-02 |
| 1083248827 | Jennifer Knuckles | Social Worker | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2020-03-02 |
| 1437783271 | Maegan Callebs | Social Worker | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2020-03-02 |
| 1992339733 | Jade E Bailey | Social Worker | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2020-03-02 |
| 1427682236 | Pamela Pitts | Counselor | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2020-03-02 |
| 1023642824 | Jennifer Dieman | Counselor | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2020-03-02 |
| 1033760210 | Nicole Testory | Behavioral Analyst | 925 Dudley Pike, Edgewood, KY 41017-8120 | 2019-09-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
| 1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
| 1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
| 1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
| 1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
| 1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
| 1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
| 1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
| 1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
| Find all providers in zip 41017 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528582269 | Steth Corporation | Community/Behavioral Health | 661 Harr Park Ct, Edgewood, MD 21040-2553 | 2017-08-02 |
| 1508387374 | Mindset Support Services | Community/Behavioral Health | 1308 Business Center Way Ste 101, Edgewood, MD 21040-1504 | 2017-07-03 |
| 1649704891 | Empowering Minds Resource Center | Community/Behavioral Health | 1833 Pulaski Hwy, Edgewood, MD 21040-1609 | 2017-04-14 |
| 1386181311 | Myers Health and Wellness LLC | Community/Behavioral Health | 3512 Sandpiper Ct, Edgewood, MD 21040-3736 | 2017-01-29 |
| 1265729677 | Therapeutic Living for Families Inc. | Community/Behavioral Health | 1837 Pulaski Highway, Edgewood, MD 21040-1446 | 2011-07-06 |
| 1932436722 | Empowering Lives Creating Possibilities Inc | Community/Behavioral Health | 3172 Ebbtide Dr, Edgewood, MD 21040-2921 | 2009-11-16 |
| 1790399293 | Changing Turn Community Healthcare Services | Community/Behavioral Health | 500 Edgewood Rd Ste 210, Edgewood, MD 21040-2734 | 2020-09-02 |
| 1467087932 | Empowering Minds Resource Center | Community/Behavioral Health | 1833 Pulaski Hwy, Edgewood, MD 21040-1641 | 2020-03-05 |
| 1467096412 | Empowering Mind Resource Center | Community/Behavioral Health | 1833 Pulaski Hwy Ste A, Edgewood, MD 21040-1654 | 2019-11-03 |
| 1356818629 | Changing Turn Community Healthcare Services | Community/Behavioral Health | 500 Edgewood Rd Ste 210, Edgewood, MD 21040-2734 | 2018-10-25 |
| Find all providers in EDGEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.