Individual provider Active NPI

Laura Marie Lines, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1477167641
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008913A Issued in IN
Practice address
9165 Otis Ave Ste 215
Indianapolis, IN 46216-2316
Phone
(317) 794-3758
NPI assigned
Sep 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 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 34008913A IN Primary

Addresses

Primary practice location

9165 Otis Ave Ste 215
Indianapolis, IN 46216-2316

Mailing address

9165 Otis Ave Ste 215
Indianapolis, IN 46216-2316
Phone (317) 794-3758

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
34008913AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amethyst Counseling LLC Clinical Current Accepting new patients

Locations

4954 E 56th St
Ste 2
Indianapolis, IN 46220
Phone (317) 252-0606

Organizations & group practices 1

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": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1477167641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9165 OTIS AVE STE 215",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462162316",
            "telephone_number": "317-794-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9165 OTIS AVE STE 215",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462162316",
            "telephone_number": "317-794-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINES",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008913A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.