Individual provider Active NPI

Charlotte M Craxton, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1487216172
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
254072 Issued in KY
Practice address
636 E Ormsby Ave
Louisville, KY 40203-2623
Phone
(502) 489-0254
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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 254072 KY Primary

Addresses

Primary practice location

636 E Ormsby Ave
Louisville, KY 40203-2623

Mailing address

636 E Ormsby Ave
Louisville, KY 40203-2623
Phone (502) 489-0254

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
I20200125000234 KY Practitioner - Clinical Social Worker 3173958873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Louisville School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1949 Goldsmith LN
Suite 103
Louisville, KY 40218-3096
Phone (502) 383-9771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
254072KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hopeful Journeys CurrentSince Jan 12, 2021 Accepting new patients

Locations

1949 Goldsmith Ln
Ste 103
Louisville, KY 40218
Phone (502) 221-7892

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1487216172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 E ORMSBY AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032623",
            "telephone_number": "502-489-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 E ORMSBY AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032623",
            "telephone_number": "502-489-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAXTON",
        "first_name": "CHARLOTTE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.