Autumn Caddell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

104 S Front Ave
Prestonsburg, KY 41653-1614

Phone

(606) 886-8572

Fax

(606) 886-4433

NPI assigned

Nov 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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 and National Provider Directory roles.

• Mountain Comprehensive Care Center, Inc.

  • Mental Health Counselor
  • Prestonsburg, KY
  • NPI 1760491674
  Medicare reassignment NPD
• Pathways Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ashland, KY
  • NPI 1982615043
  Medicare reassignment NPD
• Mountain Comprehensive Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Belfry, KY
  • NPI 1194224717
  NPD
• Mountain Comprehensive Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Paintsville, KY
  • NPI 1699386078
  NPD
• Pathways, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ashland, KY
  • NPI 1609260199
  NPD

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1083166235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADDELL",
        "first_name": "AUTUMN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "252342",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virgil Ryan Butcher, LCSW
• Ashley Butler, LPCC
• James Adam Butler, LPCC
• Kennedy Butler
• Alicia Byrd
• Jody Cain
• Lucy Calderon
• Kimberly Calhoun, LPCC
• Krista Calhoun
• Shelia Calhoun

• Clinical Social Worker in Prestonsburg, KY
• Providers in Prestonsburg, 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 Jun 29, 2021; 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.