Individual provider Active NPI

Tana J Wright, LCSW

  • Clinical Social Worker
  • Lebanon, KY
National Provider Identifier
1083743702
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3465 Issued in KY
Practice address
774 Howard Ave
Lebanon, KY 40033-1833
Phone
(502) 365-0838
Fax
(502) 371-0760
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5190 KY
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 3465 KY Primary

Addresses

Primary practice location

774 Howard Ave
Lebanon, KY 40033-1833

Mailing address

774 Howard Ave
Lebanon, KY 40033-1833
Phone (502) 365-0838

Other identifiers 1

IdentifierTypeStateIssuer
7100161110MedicaidKY

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
I20110425000452 KY Practitioner - Clinical Social Worker 9537344197 Practice locations: Louisville, KY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3038 Breckenridge LN
Suite 201
Louisville, KY 40220-2195
Phone (502) 365-0838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3465KYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1083743702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 HOWARD AVE",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331833",
            "telephone_number": "502-365-0838",
            "fax_number": "502-371-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 HOWARD AVE",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331833",
            "telephone_number": "502-365-0838",
            "fax_number": "502-371-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "TANA",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "5190",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100161110",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, KY

Sources for this page

Verify at the official NPI Registry.