Individual provider Active NPI

Brenda L Goetz, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1750481222
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1339 Issued in KY
Practice address
101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Phone
(502) 589-8600
NPI assigned
Sep 25, 2006
Last updated
Oct 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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 1339 KY Primary

Addresses

Primary practice location

101 W Muhammad Ali Blvd
Louisville, KY 40202-1423

Mailing address

101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Phone (502) 589-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110613000652 KY Practitioner - Clinical Social Worker 9739366147 Reassigns benefits to 1 organization
I20240507001980 IN Practitioner - Clinical Social Worker 9739366147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

828 Lane Allen Rd
Suite 219
Lexington, KY 40504-3659
Phone (260) 483-9081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Extended Care Specialists, Inc Clinical CurrentSince May 1, 2024 Accepting new patients

Locations

3512 Stellhorn Rd
Fort Wayne, IN 46815

8398 Mississippi St
Fl 2
Merrillville, IN 46410

828 Lane Allen Rd
Ste 219
Lexington, KY 40504

Organizations & group practices 1

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1750481222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423",
            "telephone_number": "502-589-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423",
            "telephone_number": "502-589-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZ",
        "first_name": "BRENDA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.