Individual provider Active NPI

Lonnie Lyles, LCSW

  • Clinical Social Worker
  • Owensboro, KY
National Provider Identifier
1598059552
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3849 Issued in KY
Practice address
1401 -C Spring Bank Dr Ste 6
Owensboro, KY 42303
Phone
(270) 791-8550
NPI assigned
Jun 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1036 KY
Clinical Social Worker 1041C0700X 3849 KY Primary

Addresses

Primary practice location

1401 -C Spring Bank Dr Ste 6
Owensboro, KY 42303

Mailing address

1401 Spring Bank Dr Ste 6C
Owensboro, KY 42303-7553
Phone (270) 791-8550

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
I20160331002702 KY Practitioner - Clinical Social Worker 0345547659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Counseling Connections LLC 5 clinicians

Practice addresses (Care Compare)

1326 W 9TH St
Owensboro, KY 42301-2028
Phone (270) 240-1076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1036KYMDProfessional Counselor
3849KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Leap LLC Addiction (Substance Use Disorder) CurrentSince Dec 1, 2024 Accepting new patients
Counseling Connections, LLC Clinical CurrentSince Jan 13, 2018 Accepting new patients

Locations

1858 Triplett St
Owensboro, KY 42303
Phone (270) 414-0145

1401 Spring Bank Dr
Ste 1
Owensboro, KY 42303
Phone (270) 240-1076

1326 W 9th St
Owensboro, KY 42301
Phone (270) 240-1076

Organizations & group practices 2

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": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1598059552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SPRING BANK DR STE 6C",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423037553",
            "telephone_number": "270-791-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 -C SPRING BANK DR STE 6",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "42303",
            "telephone_number": "270-791-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLES",
        "first_name": "LONNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "1036",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.