Individual provider Active NPI

Ellen Livengood

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1104471960
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25316 Issued in KY
Practice address
1177 Kalone Way
Lexington, KY 40515-5432
Phone
(859) 707-5910
NPI assigned
Aug 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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 25316 KY Primary

Addresses

Primary practice location

1177 Kalone Way
Lexington, KY 40515-5432

Mailing address

1177 Kalone Way
Lexington, KY 40515-5432
Phone (859) 707-5910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25316KYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1104471960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 KALONE WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405155432",
            "telephone_number": "859-707-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 KALONE WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405155432",
            "telephone_number": "859-707-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVENGOOD",
        "first_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "25316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.