Sedetria Sumerall, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3592 Issued in KY

Practice address

3715 Bardstown Rd Ste 300
Louisville, KY 40218-2268

Phone

(502) 777-2404

Fax

(888) 607-7352

NPI assigned

Jul 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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.

• S. Nicole Crawford, LCSW, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Louisville, KY
  • NPI 1831739689
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1164652863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11135 FANTASY TRL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402295514",
            "telephone_number": "502-777-2404",
            "fax_number": "888-607-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 BARDSTOWN RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402182268",
            "telephone_number": "502-777-2404",
            "fax_number": "888-607-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMERALL",
        "first_name": "SEDETRIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100271820",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie E Sullivan, LMT
• Virginia Sullivan, LCSW, LCADC
• Sultana Faiyaz Corporation, LLC
• Kwok Leung Bryan Sum, PHARM D
• Thimira Sumanasekera, PHARMD
• William Summay
• Carol M Summe, D.M.D.
• Summer Lewis, Cfa, LLC
• Ashley Elizabeth Summers, APRN
• Derek Tyler Summers

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, 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 Jan 6, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.