Individual provider Active NPI

Susan Buckman

  • Clinical Social Worker
  • Frankfort, KY
National Provider Identifier
1063977759
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
253856 Issued in KY
Practice address
1030 Burlington LN Ste 4
Frankfort, KY 40601-8785
Phone
(502) 320-3697
NPI assigned
Feb 6, 2019
Last updated
May 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Clinical Social Worker 1041C0700X 253856 KY Primary

Addresses

Primary practice location

1030 Burlington LN Ste 4
Frankfort, KY 40601-8785

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181

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
I20190228002176 KY Practitioner - Clinical Social Worker 8022357474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

553 Clay Lick Rd
Salvisa, KY 40372-9577
Phone (502) 382-6066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
253856KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Counties Services, Inc. Clinical CurrentSince Jan 26, 2019 Accepting new patients
Wishing Tree Counseling Clinical CurrentSince Jul 1, 2019 Accepting new patients

Locations

1030 Burlington Ln
Ste 4
Frankfort, KY 40601
Phone (502) 320-3697

10101 Linn Station Rd
Louisville, KY 40223
Phone (888) 388-4622

10401 Linn Station Rd
Ste 100
Louisville, KY 40223

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

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, 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": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1063977759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 BURLINGTON LN STE 4",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406018785",
            "telephone_number": "502-320-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKMAN",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, KY

Sources for this page

Verify at the official NPI Registry.