Individual provider Active NPI

Rebecca Woodrow

  • Clinical Social Worker
  • Bowling Green, KY
National Provider Identifier
1013090984
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
KY-1188 Issued in KY
Practice address
1910 Lyda Ave
Bowling Green, KY 42104-3326
Phone
(270) 904-6567
Fax
(270) 904-6570
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X KY-1188 KY Primary

Addresses

Primary practice location

1910 Lyda Ave
Bowling Green, KY 42104-3326

Mailing address

104 Reynolds Rd
Glasgow, KY 42141-1177

Other practice location 1

104 Reynolds Rd
Glasgow, KY 42141-1177
Phone (270) 678-4801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000026 KY Practitioner - Clinical Social Worker 0547458663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifeskills, IncGroup PAC ID 8820902638, 47 clinicians

Practice addresses (Care Compare)

380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY-1188KYMDClinical Social Worker
1188KYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeskills, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Alliance Counseling Associates Clinical CurrentSince May 5, 2024 Accepting new patients

Locations

8324 Eagle Way
Chicago, IL 60678

380 Suwannee Trail St
Bowling Green, KY 42103

1910 Lyda Ave
Bowling Green, KY 42104
Phone (270) 479-6904

104 Reynolds Rd
Glasgow, KY 42141
Phone (270) 678-4801

608 Happy Valley Rd
Glasgow, KY 42141
Phone (270) 651-8379

735 North Dr
Hopkinsville, KY 42240
Phone (270) 886-5163

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1013090984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 REYNOLDS RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 LYDA AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043326",
            "telephone_number": "270-904-6567",
            "fax_number": "270-904-6570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Reynolds Rd",
            "address_purpose": "LOCATION",
            "city": "Glasgow",
            "state": "KY",
            "postal_code": "421411177",
            "country_code": "US",
            "telephone_number": "270-678-4801",
            "fax_number": "270-678-3866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODROW",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "KY-1188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.