Active NPI
Alicia Golden Chisholm, LCSW
- Clinical Social Worker
- Louisville, KY
National Provider Identifier
1023063252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3215
- Practice address
- 2020 Newburg Rd
Louisville, KY 40205-1803 - Phone
- (502) 479-4287
- NPI assigned
- May 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3215 | KY | Primary |
Addresses
Primary practice location
2020 Newburg Rd
Louisville, KY 40205-1803
Mailing address
2020 Newburg Rd
Louisville, KY 40205-1803
Phone (502) 479-4287
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3215 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480291200000",
"number": "1023063252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 NEWBURG RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402051803",
"telephone_number": "502-479-4287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 NEWBURG RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402051803",
"telephone_number": "502-479-4287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHISHOLM",
"first_name": "ALICIA",
"middle_name": "GOLDEN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-24",
"last_updated": "2016-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "3215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790731081",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
- Chiropractic and Medical Center LLC
- Chiropractic Health Care Center Inc.
- Chiropractic Louisville PLLC
- Chiropractic Rehab and Sports Injuries of Louisville
- Chiropractic Solutions PLLC
- Saima Chishti, PA-C
- Corey Peyton Chitwood
- Chmiel, Murphy, & Secor, PSC
- Stanley S. Chmiel, M.D.
- Christine L Chmielewski, LMFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.