KAYLA MARIE BROCK-PROVENCHER CSW
NPI 1922782507
Social Worker - Clinical in Louisville, KY

Q: What is Kayla Brock-provencher's NPI number?

The NPI number for Kayla Brock-provencher is 1922782507. It was assigned to this individual provider in the NPPES registry on June 14, 2023.

Q: What is Kayla Brock-provencher's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since June 14, 2023PECOS EnrolledAccepts Medicare Assignment

10300 BROOKRIDGE VILLAGE BLVD STE 104, LOUISVILLE, KY 40291(502) 785-4322 Get Directions Write a Review

NPPES record last updated: June 14, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kayla Marie Brock-provencher Csw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAYLA MARIE BROCK-PROVENCHER CSW (NPI 1922782507) is an individual clinical provider in Louisville, Kentucky, licensed in Kentucky (258016) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1922782507

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameKAYLA MARIE BROCK-PROVENCHERCredential: CSW

Location Address10300 BROOKRIDGE VILLAGE BLVD STE 104Louisville, KY 40291-4474

Mailing Address10030 Brookridge Village Blvd, Suite 104Louisville, KY 40291

Phone(502) 785-4322

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJune 14, 2023

NPPES CertifiedJune 5, 2023

✔ NPI 1922782507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in KY · 258016

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

10300 BROOKRIDGE VILLAGE BLVD STE 104, Louisville, KY 40291

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kayla Marie Brock-provencher Csw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466969977

PECOS Enrollment IDI20250729004086

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40291 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $52.76 – $162.27

Typical copayment $0.00 (range $13.19 – $40.56)

Most-billed visit code NA

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VANESSA NICOLE JONES

Social Worker (Clinical)

10300 BROOKRIDGE VILLAGE BLVD STE 104, APT 202
LOUISVILLE, KY 40291

Jefferson County (901) 679-3563

BRENNA TEEGARDEN

Marriage & Family Therapist