Individual provider Active NPI

Lafayette Brown III, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1578084141
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
254539 Issued in KY
Practice address
3934 Dixie Hwy Ste 102
Louisville, KY 40216-4163
Phone
(502) 287-4176
NPI assigned
Jul 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 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 254539 KY Primary

Addresses

Primary practice location

3934 Dixie Hwy Ste 102
Louisville, KY 40216-4163

Mailing address

PO Box 1454
Bardstown, KY 40004-4454
Phone (502) 496-3300

Other practice location 1

10101 Linn Station Rd
Louisville, KY 40223-3848
Phone (502) 589-8600

Other identifiers 2

IdentifierTypeStateIssuer
7100641040MedicaidKY
K31710MedicaidKY

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1578084141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1454",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400044454",
            "telephone_number": "502-496-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3934 DIXIE HWY STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164163",
            "telephone_number": "502-287-4176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10101 Linn Station Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402233848",
            "country_code": "US",
            "telephone_number": "502-589-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LAFAYETTE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-04",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100641040",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K31710",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.