Individual provider Active NPI

Tonya Nicole Keen Glover, LCSW

  • Clinical Social Worker
  • Columbia, KY
National Provider Identifier
1477295657
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
256490 Issued in KY
Practice address
112 Office Park Dr
Columbia, KY 42728-1380
Phone
(270) 634-4324
NPI assigned
Apr 8, 2022
Last updated
Apr 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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 256490 KY Primary

Addresses

Primary practice location

112 Office Park Dr
Columbia, KY 42728-1380

Mailing address

112 Office Park Dr
Columbia, KY 42728-1380
Phone (270) 634-4324

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tonya.glover@lc-caa.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20230323000395 KY Practitioner - Clinical Social Worker 8123492659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serenity Counseling Services LLCGroup PAC ID 0143694927, 6 clinicians

Practice addresses (Care Compare)

112 Office Park Dr
Columbia, KY 42728-1380
Phone (270) 864-1625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
256490KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Counseling Services LLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

112 Office Park Dr
Columbia, KY 42728
Phone (270) 634-4324

633 Main St
Russell Springs, KY 42642
Phone (270) 864-1625

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, 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": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1477295657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 OFFICE PARK DR",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427281380",
            "telephone_number": "270-634-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 OFFICE PARK DR",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427281380",
            "telephone_number": "270-634-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN GLOVER",
        "first_name": "TONYA",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tonya.glover@lc-caa.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "112 Office Park Dr",
            "city": "Columbia",
            "state": "KY",
            "country_code": "US",
            "postal_code": "427281380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, KY

Sources for this page

Verify at the official NPI Registry.