Individual provider Active NPI

Angela Whittle-Douthitt, LCSW

  • Clinical Social Worker
  • Fordsville, KY
National Provider Identifier
1194689190
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW00001290 Issued in KY
Practice address
313 W Main St
Fordsville, KY 42343-9763
Phone
(502) 262-2887
NPI assigned
Dec 13, 2025
Last updated
May 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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 LCSW00001290 KY Primary

Addresses

Primary practice location

313 W Main St
Fordsville, KY 42343-9763

Mailing address

15 Serena Cir
Leitchfield, KY 42754-5703
Phone (270) 307-1822

Other practice location 1

720 W Main St
Clarkson, KY 42726-7048
Phone (270) 904-5104

Other practice location 2

106 Diecks Dr
Elizabethtown, KY 42701-2443
Phone (502) 262-2887

Other identifiers 1

IdentifierTypeStateIssuer
7101117180MedicaidKY

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
I20260122000222 KY Practitioner - Clinical Social Worker 9830676774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PPL Therapeutic Services PLLCGroup PAC ID 8527323989, 30 clinicians
KW Consulting LLCGroup PAC ID 6901291756, 26 clinicians

Practice addresses (Care Compare)

106 Diecks Dr
Elizabethtown, KY 42701-2443
Phone (270) 737-2738

5966 Scottsville Rd
Suite 3
Bowling Green, KY 42104-7908
Phone (270) 904-5104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW00001290KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KW Consulting, LLC Single Specialty CurrentSince Jan 1, 2026 Accepting new patients
Fuller Life Health and Wellness PastSince Dec 14, 2025 Accepting new patients

Locations

5966 Scottsville Rd
Ste 3
Bowling Green, KY 42104
Phone (270) 791-8189

720 W Main St
Clarkson, KY 42726
Phone (270) 904-5104

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": "1765584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1194689190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SERENA CIR",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427545703",
            "telephone_number": "270-307-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W MAIN ST",
            "city": "FORDSVILLE",
            "state": "KY",
            "postal_code": "423439763",
            "telephone_number": "502-262-2887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 W Main St",
            "address_purpose": "LOCATION",
            "city": "Clarkson",
            "state": "KY",
            "postal_code": "427267048",
            "country_code": "US",
            "telephone_number": "270-904-5104",
            "fax_number": "270-201-5980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Diecks Dr",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427012443",
            "country_code": "US",
            "telephone_number": "502-262-2887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITTLE-DOUTHITT",
        "first_name": "ANGELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-13",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "LCSW00001290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101117180",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fordsville, KY

Sources for this page

Verify at the official NPI Registry.