Individual provider Active NPI

Misty April Nunn, LCSW

  • Clinical Social Worker
  • Manchester, KY
National Provider Identifier
1437558293
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5134 Issued in KY
Practice address
409 Richmond Rd
Manchester, KY 40962-1373
Phone
(606) 594-7479
NPI assigned
Aug 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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 6939 KY
Clinical Social Worker 1041C0700X 5134 KY Primary

Addresses

Primary practice location

409 Richmond Rd
Manchester, KY 40962-1373

Mailing address

PO Box 568
Corbin, KY 40702-0568

Other identifiers 1

IdentifierTypeStateIssuer
7100403190MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230117001202 MA Practitioner - Clinical Social Worker 2264727437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Kentucky College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

332 Birnie Ave
Springfield, MA 01107-1104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6939KYMDClinical Social Worker
5134KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Human Development, Inc. Clinical CurrentSince Dec 5, 2022 Accepting new patients
Center for Human Development, Inc CurrentSince Dec 5, 2022 Accepting new patients

Locations

131 W Main St
#1
Orange, MA 01364
Phone (978) 544-2148

131 W Main St
Fl 1
Orange, MA 01364

332 Birnie Ave
Springfield, MA 01107
Phone (413) 439-2189

367 Pine St
Springfield, MA 01105
Phone (413) 737-1426

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": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1437558293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407020568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 RICHMOND RD",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409621373",
            "telephone_number": "606-594-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNN",
        "first_name": "MISTY",
        "middle_name": "APRIL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "6939",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "5134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100403190",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

Verify at the official NPI Registry.