Active NPI
George Quisenberry, LCSW
- Clinical Social Worker
- Scottsville, KY
National Provider Identifier
1508889486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0959
- Practice address
- 512 Bowling Green Rd
Scottsville, KY 42164-8303 - Phone
- (270) 237-4481
- Fax
- (270) 237-4858
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0959 | KY | Primary |
Addresses
Primary practice location
512 Bowling Green Rd
Scottsville, KY 42164-8303
Mailing address
922 State St
P O Box 6499
Bowling Green, KY 42101-2233
Phone (270) 901-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30604011 | Medicaid | KY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0959 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1508889486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "922 STATE ST",
"address_2": "P O BOX 6499",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421012233",
"telephone_number": "270-901-5000",
"fax_number": "270-842-5268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 BOWLING GREEN RD",
"city": "SCOTTSVILLE",
"state": "KY",
"postal_code": "421648303",
"telephone_number": "270-237-4481",
"fax_number": "270-237-4858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUISENBERRY",
"first_name": "GEORGE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "0959",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30604011",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scottsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.