Individual provider Active NPI

Lucille Lee McMichael, LCSW

  • Clinical Social Worker
  • Bowling Green, KY
National Provider Identifier
1801033980
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3277 Issued in KY
Practice address
1830 Destiny LN 112
Bowling Green, KY 42104-1089
Phone
(270) 746-9995
Fax
(270) 393-9001
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 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 3277 KY Primary

Addresses

Primary practice location

1830 Destiny LN 112
Bowling Green, KY 42104-1089

Mailing address

1830 Destiny LN
Suite 112
Bowling Green, KY 42104-1087
Phone (270) 779-7312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20241120002214 AL Practitioner - Clinical Social Worker 3779636436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pike Road Counseling LLCGroup PAC ID 3476998329, 3 clinicians

Practice addresses (Care Compare)

10519 Vaughn Rd
Pike Road, AL 36064-2700
Phone (334) 603-1427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pike Road Counseling, LLC CurrentSince Aug 31, 2024 Accepting new patients

Locations

10519 Vaughn Rd
Pike Road, AL 36064
Phone (334) 531-6088

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1801033980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 DESTINY LN",
            "address_2": "SUITE 112",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421041087",
            "telephone_number": "270-779-7312",
            "fax_number": "270-393-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 DESTINY LN 112",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421041089",
            "telephone_number": "270-746-9995",
            "fax_number": "270-393-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMICHAEL",
        "first_name": "LUCILLE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.