Active NPI
Letitia V Haywood, LCSW
- Clinical Social Worker
- Lebanon, IN
National Provider Identifier
1639396344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34005683A
- Practice address
- 940 Lasley Dr
Lebanon, IN 46052-1480 - Phone
- (888) 714-1927
- Fax
- (317) 745-9565
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34005683A | IN | Primary |
Addresses
Primary practice location
940 Lasley Dr
Lebanon, IN 46052-1480
Mailing address
11429 Scheel LN
Carmel, IN 46032-3470
Phone (317) 582-0063
Other practice location 1
11429 Scheel Ln
Carmel, IN 46032-3470
Phone (317) 582-0063
Other practice location 2
8320 Madison Ave
Indianapolis, IN 46227-6066
Phone (317) 882-5122
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200936060A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34005683A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567036800000",
"number": "1639396344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11429 SCHEEL LN",
"city": "CARMEL",
"state": "IN",
"postal_code": "460323470",
"telephone_number": "317-582-0063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 LASLEY DR",
"city": "LEBANON",
"state": "IN",
"postal_code": "460521480",
"telephone_number": "888-714-1927",
"fax_number": "317-745-9565"
}
],
"practiceLocations": [
{
"address_1": "11429 Scheel Ln",
"address_purpose": "LOCATION",
"city": "Carmel",
"state": "IN",
"postal_code": "460323470",
"country_code": "US",
"telephone_number": "317-582-0063",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8320 Madison Ave",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462276066",
"country_code": "US",
"telephone_number": "317-882-5122",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAYWOOD",
"first_name": "LETITIA",
"middle_name": "V",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2019-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34005683A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200936060A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.