Individual provider Active NPI

Hope Phelon, LCSW. LAT

  • Clinical Social Worker
  • Newcastle, WY
National Provider Identifier
1023163391
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-173 Issued in WY
Practice address
420 Deanne Ave
Newcastle, WY 82701-2936
Phone
(307) 746-4456
Fax
(307) 746-4470
NPI assigned
Jan 24, 2007
Last updated
Oct 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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 LCSW-173 WY Primary

Addresses

Primary practice location

420 Deanne Ave
Newcastle, WY 82701-2936

Mailing address

1841 Madora Ave
Douglas, WY 82633-3057
Phone (307) 358-2846

Other identifiers 2

IdentifierTypeStateIssuer
106402907MedicaidWY
106402908MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20100120000218 WY Practitioner - Clinical Social Worker 7618019290 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-173WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
High Country Behavioral Health CurrentSince Mar 3, 2022 Accepting new patients
High Country Behavioral Health Current Accepting new patients
High Country Behavioral Health CurrentSince Mar 3, 2022 Accepting new patients

Locations

1248 E 17th St
Idaho Falls, ID 83404
Phone (208) 542-1026

1841 Madora Ave
Douglas, WY 82633

1841 Madora Ave
Ste 1
Douglas, WY 82633

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1023163391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 MADORA AVE",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826333057",
            "telephone_number": "307-358-2846",
            "fax_number": "307-358-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DEANNE AVE",
            "city": "NEWCASTLE",
            "state": "WY",
            "postal_code": "827012936",
            "telephone_number": "307-746-4456",
            "fax_number": "307-746-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELON",
        "first_name": "HOPE",
        "credential": "LCSW. LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106402907",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106402908",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newcastle, WY

Sources for this page

Verify at the official NPI Registry.