Individual provider Active NPI

Whitney Vincent, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1548907967
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
256789 Issued in KY
Practice address
109 S Spring St
Louisville, KY 40206-1952
Phone
(502) 338-0747
NPI assigned
May 17, 2022
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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 256789 KY Primary

Addresses

Primary practice location

109 S Spring St
Louisville, KY 40206-1952

Mailing address

109 S Spring St
Louisville, KY 40206-1952
Phone (502) 338-0747

Other practice location 1

2250 Thunderstick Dr Ste 1104
Lexington, KY 40505-9009
Phone (859) 254-1035

Other identifiers 1

IdentifierTypeStateIssuer
7100871000MedicaidKY

Other names 1

  • Whitney Young Former name

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
I20230120001840 KY Practitioner - Clinical Social Worker 9335510882 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KVC Behavioral Healthcare Kentucky Inc Clinical CurrentSince Nov 9, 2022 Accepting new patients

Locations

2250 Thunderstick Dr
Ste 1104
Lexington, KY 40505
Phone (859) 254-1305

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": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1548907967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S SPRING ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061952",
            "telephone_number": "502-338-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S SPRING ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061952",
            "telephone_number": "502-338-0747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 Thunderstick Dr Ste 1104",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405059009",
            "country_code": "US",
            "telephone_number": "859-254-1035",
            "fax_number": "859-254-2075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "WHITNEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100871000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WHITNEY",
            "last_name": "YOUNG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.