Individual provider Active NPI

Lindsay Elizabeth Hutchinson, LCSW

  • Clinical Social Worker
  • Jackson, TN
National Provider Identifier
1609957661
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW5074 Issued in TN
Practice address
45 Executive Dr
Jackson, TN 38305-2337
Phone
(731) 664-2083
Fax
(731) 658-1988
NPI assigned
Oct 18, 2006
Last updated
Mar 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 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 LSW5074 TN Primary

Addresses

Primary practice location

45 Executive Dr
Jackson, TN 38305-2337

Mailing address

45 Executive Dr
Jackson, TN 38305-2337
Phone (731) 664-2083

Other identifiers 2

IdentifierTypeStateIssuer
1513363MedicaidTN
4285695OtherBCBS

Other names 1

  • Lindsay Elizabeth Homesley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20090608000017 TN Practitioner - Clinical Social Worker 1456401801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Health Centers and Clinics of TennesseeGroup PAC ID 3678475621, 13 clinicians

Practice addresses (Care Compare)

10710 Old Hwy 64
Bolivar, TN 38008-3587
Phone (731) 658-6113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW5074TNMDClinical Social Worker
5074TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Centers & Clinics of Tennessee CurrentSince Jan 24, 2011 Accepting new patients

Locations

10710 Old Highway 64
Bolivar, TN 38008
Phone (731) 658-6113

45 Executive Dr
Jackson, TN 38305
Phone (731) 664-2083

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1609957661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 EXECUTIVE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052337",
            "telephone_number": "731-664-2083",
            "fax_number": "731-658-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 EXECUTIVE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052337",
            "telephone_number": "731-664-2083",
            "fax_number": "731-658-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "LINDSAY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW5074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513363",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4285695",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "HOMESLEY",
            "middle_name": "ELIZABETH",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.