Individual provider Active NPI

Patsy E Odom, LCSW

  • Clinical Social Worker
  • Lawrenceburg, TN
National Provider Identifier
1780748830
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW0000004354 Issued in TN
Practice address
24 Public Square
Lawrenceburg, TN 38464
Phone
(931) 762-8883
Fax
(931) 762-8820
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LSW0000004354 TN Primary

Addresses

Primary practice location

24 Public Square
Lawrenceburg, TN 38464

Mailing address

PO Box 564
Lawrenceburg, TN 38464
Phone (931) 762-8883

Other identifiers 1

IdentifierTypeStateIssuer
4077658OtherTNBCBS

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
LSW0000004354TNMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780748830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 564",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "38464",
            "telephone_number": "931-762-8883",
            "fax_number": "931-762-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PUBLIC SQUARE",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "38464",
            "telephone_number": "931-762-8883",
            "fax_number": "931-762-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "PATSY",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4077658",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.