Individual provider Active NPI

Haley C Bosemer, LCSW, LCADC

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1629781224
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
257835 Issued in KY
Practice address
914 E Broadway
Louisville, KY 40204-1037
Phone
(502) 589-8600
NPI assigned
Dec 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 257835 KY Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 272854 KY

Addresses

Primary practice location

914 E Broadway
Louisville, KY 40204-1037

Mailing address

10401 Linn Station Rd Ste 100
Louisville, KY 40223-3842
Phone (502) 589-8600

Other practice location 1

1949 Goldsmith Ln
Louisville, KY 40218-3086
Phone (502) 544-6204

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
I20230421001151 KY Practitioner - Clinical Social Worker 7719342906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seven Counties Services, IncGroup PAC ID 1759294424, 92 clinicians

Practice addresses (Care Compare)

1949 Goldsmith LN
Suite 103
Louisville, KY 40218-3096
Phone (502) 544-6204

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 589-1100

914 E Broadway
Louisville, KY 40204-1037
Phone (502) 587-8833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
272854KYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Zen Quality Therapy Solutions LLC Addiction (Substance Use Disorder) CurrentSince Jun 1, 2023 Accepting new patients
Seven Counties Services, Inc. Addiction (Substance Use Disorder) CurrentSince Apr 13, 2023 Accepting new patients

Locations

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

10401 Linn Station Rd
Ste 100
Louisville, KY 40223

1949 Goldsmith Ln
Ste 103
Louisville, KY 40218
Phone (502) 221-7892

914 E Broadway
Louisville, KY 40204
Phone (502) 587-8833

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": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1629781224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 LINN STATION RD STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233842",
            "telephone_number": "502-589-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 E BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041037",
            "telephone_number": "502-589-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1949 Goldsmith Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402183086",
            "country_code": "US",
            "telephone_number": "502-544-6204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSEMER",
        "first_name": "HALEY",
        "middle_name": "C",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-29",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "257835",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "272854",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.