Individual provider Active NPI

Aimee Lynne Harrell, LCSW

  • Clinical Social Worker
  • Lafayette, IN
National Provider Identifier
1417287624
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005464A Issued in IN
Practice address
4010 Druze Ave
Lafayette, IN 47909-8259
Phone
(765) 588-7196
NPI assigned
Jan 11, 2010
Last updated
Apr 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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 34005464A IN Primary

Addresses

Primary practice location

4010 Druze Ave
Lafayette, IN 47909-8259

Mailing address

4010 Druze Ave
Lafayette, IN 47909-8259
Phone (765) 588-7196

Other practice location 1

306 Plantation Way
Lafayette, IN 47909-6822
Phone (765) 430-2977

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
34005464AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Behavior Consulting CurrentSince May 26, 2024 Accepting new patients
Positive Pathways Counseling and Consulting, LLC Past Accepting new patients

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, 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": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1417287624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DRUZE AVE",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479098259",
            "telephone_number": "765-588-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DRUZE AVE",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479098259",
            "telephone_number": "765-588-7196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 Plantation Way",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479096822",
            "country_code": "US",
            "telephone_number": "765-430-2977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "AIMEE",
        "middle_name": "LYNNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005464A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.