Individual provider Active NPI

Melody Suzanne Hickman-Horvath, LCSW

  • Clinical Social Worker
  • Newport, TN
National Provider Identifier
1194723379
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW4592 Issued in TN
Practice address
215 Hedrick Dr
Newport, TN 37821-2902
Phone
(423) 623-5301
Fax
(423) 625-0808
NPI assigned
Jul 12, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW 5982 TN
Clinical Social Worker 1041C0700X LSW4592 TN Primary

Addresses

Primary practice location

215 Hedrick Dr
Newport, TN 37821-2902

Mailing address

Department 888182
Knoxville, TN 37995-0001
Phone (800) 355-3565

Other identifiers 1

IdentifierTypeStateIssuer
39839773MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW 5982TNMDClinical Social Worker
LSW4592TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194723379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT 888182",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379950001",
            "telephone_number": "800-355-3565",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HEDRICK DR",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378212902",
            "telephone_number": "423-623-5301",
            "fax_number": "423-625-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN-HORVATH",
        "first_name": "MELODY",
        "middle_name": "SUZANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "CSW 5982",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW4592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39839773",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.