Individual provider Active NPI

Laura Ellen Hylbert, LCSW, ASDCS

  • Clinical Social Worker
  • Wilmore, KY
National Provider Identifier
1760031942
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
255355 Issued in KY
Practice address
304 E Main St Ste 5
Wilmore, KY 40390-1375
Phone
(888) 816-1469
Fax
(859) 788-2014
NPI assigned
Sep 10, 2019
Last updated
Jul 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6095 KY
Clinical Social Worker 1041C0700X 255355 KY Primary

Addresses

Primary practice location

304 E Main St Ste 5
Wilmore, KY 40390-1375

Mailing address

304 E Main St Ste 5
Wilmore, KY 40390-1375
Phone (888) 816-1469

Other identifiers 1

IdentifierTypeStateIssuer
1790731081MedicaidKY

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

LicenseStateTypeSpecialty
6095KYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Puzzle Peace Creative Counseling Solutions Clinical CurrentSince Aug 8, 2021 Accepting new patients

Locations

304 E Main St
Ste 5
Wilmore, KY 40390
Phone (888) 816-1469

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1760031942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 E MAIN ST STE 5",
            "city": "WILMORE",
            "state": "KY",
            "postal_code": "403901375",
            "telephone_number": "888-816-1469",
            "fax_number": "859-788-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 E MAIN ST STE 5",
            "city": "WILMORE",
            "state": "KY",
            "postal_code": "403901375",
            "telephone_number": "888-816-1469",
            "fax_number": "859-788-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYLBERT",
        "first_name": "LAURA",
        "middle_name": "ELLEN",
        "credential": "LCSW, ASDCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "6095",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmore, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.