Individual provider Active NPI

Lora Christi Dukes, LCSW

  • Social Worker
  • Waycross, GA
National Provider Identifier
1700487782
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
14050 Issued in SC
Practice address
612 Kenwood Dr
Waycross, GA 31501-6904
Phone
(912) 288-8531
NPI assigned
Nov 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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 CSW007327 GA
Social Worker 104100000X 14050 SC Primary

Addresses

Primary practice location

612 Kenwood Dr
Waycross, GA 31501-6904

Mailing address

612 Kenwood Dr
Waycross, GA 31501-6904
Phone (912) 288-8531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20210216000040 SC Practitioner - Clinical Social Worker 0547675035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Itrust Wellness GroupGroup PAC ID 0648532028, 18 clinicians

Practice addresses (Care Compare)

149 Commons Way
Greenville, SC 29611-3850
Phone (864) 520-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14050SCMDSocial Worker
CSW007327GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Itrust Wellness Group CurrentSince Mar 1, 2021 Accepting new patients
Itrust Cares LLC PastSince Mar 1, 2021 Accepting new patients

Locations

149 Commons Way
Greenville, SC 29611

765 Haywood Rd
Ste I
Greenville, SC 29607

121 Commons Way
Greenville, SC 29611

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": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1700487782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 KENWOOD DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016904",
            "telephone_number": "912-288-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 KENWOOD DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016904",
            "telephone_number": "912-288-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKES",
        "first_name": "LORA",
        "middle_name": "CHRISTI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007327",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "14050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.