Individual provider Active NPI

Lucas Krickenbarger, LCSW

  • Clinical Social Worker
  • Richmond, IN
National Provider Identifier
1407440076
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009159A Issued in IN
Practice address
831 Dillon Dr
Richmond, IN 47374-8048
Phone
(765) 983-8000
Fax
(765) 935-3869
NPI assigned
Feb 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 34009159A IN Primary

Addresses

Primary practice location

831 Dillon Dr
Richmond, IN 47374-8048

Mailing address

645 S Rogers St
Bloomington, IN 47403-2353
Phone (812) 339-1691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210301001324 IN Practitioner - Clinical Social Worker 3274949185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerstone of Indiana IncGroup PAC ID 9436138427, 114 clinicians

Practice addresses (Care Compare)

100 N 15TH St
Richmond, IN 47374-4355
Phone (765) 983-8600

720 N Marr Rd
Columbus, IN 47201-6660
Phone (812) 314-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Indiana, Inc. Current Accepting new patients
Centerstone of Indiana, Inc. CurrentSince Feb 10, 2021 Accepting new patients

Locations

645 S Rogers St
Bloomington, IN 47403
Phone (812) 339-1691

720 N Marr Rd
Columbus, IN 47201
Phone (812) 314-3400

831 Dillon Dr
Richmond, IN 47374
Phone (765) 983-8000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1407440076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691",
            "fax_number": "812-339-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 DILLON DR",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473748048",
            "telephone_number": "765-983-8000",
            "fax_number": "765-935-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRICKENBARGER",
        "first_name": "LUCAS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009159A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.