Individual provider Active NPI

Kimberly Hage, LCSW, SAP

  • Clinical Social Worker
  • Greenfield, IN
National Provider Identifier
1629445440
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007344A Issued in IN
Practice address
635 N State St
Suite B
Greenfield, IN 46140-1400
Phone
(317) 437-5104
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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 34007344A IN Primary

Addresses

Primary practice location

635 N State St
Suite B
Greenfield, IN 46140-1400

Mailing address

152 N 600 E
Greenfield, IN 46140-8363
Phone (317) 437-5104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20151021001968 IN Practitioner - Clinical Social Worker 7416266077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

635 N State St
Suite B
Greenfield, IN 46140-3607
Phone (317) 437-5104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34007344AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oases Counseling Center Clinical CurrentSince Nov 23, 2015 Accepting new patients
Lyon Recovery Therapy Services Clinical PastSince Jan 1, 2023 Accepting new patients

Locations

635 N State St
Ste B
Greenfield, IN 46140
Phone (317) 437-5104

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, 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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1629445440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 N 600 E",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461408363",
            "telephone_number": "317-437-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 N STATE ST",
            "address_2": "SUITE B",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401400",
            "telephone_number": "317-437-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGE",
        "first_name": "KIMBERLY",
        "credential": "LCSW, SAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007344A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, IN

Sources for this page

Verify at the official NPI Registry.