Individual provider Active NPI

Angela L Feese, LCSW

  • Clinical Social Worker
  • Somerset, KY
National Provider Identifier
1639121965
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1629 Issued in KY
Practice address
341 Bogle Street
Ste a
Somerset, KY 42503-2815
Phone
(606) 678-0705
Fax
(606) 678-2807
NPI assigned
May 16, 2006
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 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 1629 KY Primary

Addresses

Primary practice location

341 Bogle Street
Ste a
Somerset, KY 42503-2815

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other identifiers 2

IdentifierTypeStateIssuer
7100279870MedicaidKY
11490013OtherCAQH

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
I20070630000003 KY Practitioner - Clinical Social Worker 0547369688 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc CurrentSince Aug 15, 2022 Accepting new patients
Lake Cumberland Regional Mental Health Mental Retardation Board, Inc. CurrentSince Feb 14, 2002 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Aug 15, 2022 Accepting new patients
Cumberland Family Medical Center Inc Past Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

200 E Frazier Ave
Columbia, KY 42728
Phone (270) 384-4710

937 Campbellsville Rd
Columbia, KY 42728
Phone (270) 384-2777

130 Southern School Rd
Somerset, KY 42501
Phone (606) 679-4782

341 Bogle St
Ste A
Somerset, KY 42503
Phone (606) 676-8186

1515 Edmonton Rd
Tompkinsville, KY 42167
Phone (270) 487-9272

Organizations & group practices 4

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1639121965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 BOGLE STREET",
            "address_2": "STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032815",
            "telephone_number": "606-678-0705",
            "fax_number": "606-678-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEESE",
        "first_name": "ANGELA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100279870",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11490013",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.