Individual provider Active NPI

Michael McCuddy, LCSW

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1356765168
Registry record updated Nov 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5127 Issued in KY
Practice address
1500 Leestown Rd
Lexington, KY 40511-2044
Phone
(859) 253-0717
NPI assigned
Feb 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2019

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 5127 KY Primary

Addresses

Primary practice location

1500 Leestown Rd
Lexington, KY 40511-2044

Mailing address

1500 Leestown Rd
Lexington, KY 40511-2044
Phone (859) 253-0717

Other practice location 1

1101 Veterans Dr
Lexington, KY 40502-2235
Phone (859) 233-4511

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5127KYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575072000000",
    "number": "1356765168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LEESTOWN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112044",
            "telephone_number": "859-253-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LEESTOWN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112044",
            "telephone_number": "859-253-0717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Veterans Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405022235",
            "country_code": "US",
            "telephone_number": "859-233-4511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCUDDY",
        "first_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-13",
        "last_updated": "2019-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "5127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2019; 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.