Individual provider Active NPI

Marcie Nicole Crain, LCSW

  • Clinical Social Worker
  • Glasgow, KY
National Provider Identifier
1164890877
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
253029 Issued in KY
Practice address
104 Reynolds Rd
Glasgow, KY 42141-1177
Phone
(270) 678-4801
Fax
(270) 678-3866
NPI assigned
Sep 11, 2015
Last updated
Nov 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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 7303 KY
Clinical Social Worker 1041C0700X 7303 KY
Clinical Social Worker 1041C0700X 253029 KY Primary

Addresses

Primary practice location

104 Reynolds Rd
Glasgow, KY 42141-1177

Mailing address

104 Reynolds Rd
Glasgow, KY 42141-1177
Phone (270) 678-4801

Other practice location 1

100 C D Locke Rd
Horse Cave, KY 42749-8045
Phone (270) 537-5302

Other practice location 2

1910 Lyda Ave
Bowling Green, KY 42104-3326
Phone (270) 904-6567

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
I20180124002750 KY Practitioner - Clinical Social Worker 1052670841 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Alliance Counseling Associates Clinical CurrentSince Jan 1, 2018 Accepting new patients
Alliance Center for Community Empowerment and Support Services, LLC Past Accepting new patients

Locations

1910 Lyda Ave
Bowling Green, KY 42104
Phone (270) 479-6904

104 Reynolds Rd
Glasgow, KY 42141
Phone (270) 678-4801

Interoperability endpoints

  • Direct secure messaging: marciecrain@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1164890877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 REYNOLDS RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411177",
            "telephone_number": "270-678-4801",
            "fax_number": "270-678-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 REYNOLDS RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411177",
            "telephone_number": "270-678-4801",
            "fax_number": "270-678-3866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 C D Locke Rd",
            "address_purpose": "LOCATION",
            "city": "Horse Cave",
            "state": "KY",
            "postal_code": "427498045",
            "country_code": "US",
            "telephone_number": "270-537-5302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1910 Lyda Ave",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421043326",
            "country_code": "US",
            "telephone_number": "270-904-6567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAIN",
        "first_name": "MARCIE",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "7303",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "7303",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.