Individual provider Active NPI

Lena Embry, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1073179370
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4602 Southern Pkwy Ste 1D
Louisville, KY 40214-1429
Phone
(502) 461-6111
Fax
(928) 202-4458
NPI assigned
May 13, 2019
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2023

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 NU Primary

Addresses

Primary practice location

4602 Southern Pkwy Ste 1D
Louisville, KY 40214-1429

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 AZ, IN, KY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190613003353 AZ Practitioner - Clinical Social Worker 6800129313 Reassigns benefits to 1 organization
I20230213001793 IN Practitioner - Clinical Social Worker 6800129313 Reassigns benefits to 1 organization
I20230331002167 KY Practitioner - Clinical Social Worker 6800129313 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4602 Southern Pkwy
Suite 1D
Louisville, KY 40214-1528
Phone (502) 461-4111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Mar 29, 2021 Accepting new patients

Locations

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

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": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1073179370",
    "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",
            "fax_number": "812-492-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 SOUTHERN PKWY STE 1D",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402141429",
            "telephone_number": "502-461-6111",
            "fax_number": "928-202-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMBRY",
        "first_name": "LENA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.