Connie Antle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3990 Issued in KY

Practice address

521 Old Hodgenville Rd
Greensburg, KY 42743-9493

Phone

(270) 932-3226

Fax

(270) 932-5328

NPI assigned

Jul 19, 2006

Last updated

Mar 3, 2016By the provider in NPPES

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 names 1

• Connie Carter Former name

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

University of Louisville School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lake Cumberland Regional Mental Health Mental Retardation Board Inc .Group PAC ID 3375536717, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Cumberland Regional Mental Health Mental Retardation Board, Inc.

  dba The Adanta Group

  • Community/Behavioral Health Agency
  • Somerset, KY
  • NPI 1336172642
  Medicare reassignment Care Compare group NPD
• Lake Cumberland Regional MHMR Board Outpatient

  dba The Adanta Group Outpatient

  • Community/Behavioral Health Agency
  • Somerset, KY
  • NPI 1992831713
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1295754067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SOUTHERN SCHOOL RD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425013223",
            "telephone_number": "606-679-4782",
            "fax_number": "606-678-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 OLD HODGENVILLE RD",
            "city": "GREENSBURG",
            "state": "KY",
            "postal_code": "427439493",
            "telephone_number": "270-932-3226",
            "fax_number": "270-932-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTLE",
        "first_name": "CONNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "CARTER",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abiding Hope Counseling
• Adult Day Health, Inc. (Just Family Center - Green)
• Adult Day Health, Inc. (Just Family Center-Green)
• Melinda Auberry
• Az Health Services LLC
• Glenda Darlene Bagby, ARNP-BC, MSN, CEN
• Heather N Bailey
• Benjamin Bentley

• Clinical Social Worker in Greensburg, KY
• Providers in Greensburg, 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 Mar 3, 2016; 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.