Lori Beth Mangan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

252940 Issued in KY

Practice address

541 Buttermilk Pike Ste 200
Crescent Springs, KY 41017-1696

Phone

(859) 869-2023

Fax

(561) 401-9196

NPI assigned

Nov 22, 2017

Last updated

Dec 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hope Behavioral Health, LLC

  • Clinical Social Worker
  • Crescent Springs, KY
  • NPI 1811548316
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1033623376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 FOX MEADOW RUN",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585504",
            "telephone_number": "859-250-6898",
            "fax_number": "561-401-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 BUTTERMILK PIKE STE 200",
            "city": "CRESCENT SPRINGS",
            "state": "KY",
            "postal_code": "410171696",
            "telephone_number": "859-869-2023",
            "fax_number": "561-401-9196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Fox Meadow Run",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334585504",
            "country_code": "US",
            "telephone_number": "859-250-6898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "116 Intracoastal Pointe Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334775024",
            "country_code": "US",
            "telephone_number": "612-779-6425",
            "fax_number": "561-401-9196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGAN",
        "first_name": "LORI",
        "middle_name": "BETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "292540",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17168",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "252940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northern Kentucky Dental Centers-Buttermilk,PLLC (Buttermilk Dental Center)

• Clinical Social Worker in Crescent Springs, KY
• Providers in Crescent Springs, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.