Individual provider Active NPI

Angela Combs, LCSW

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1841331048
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
255369 Issued in KY
Practice address
2250 Thunderstick Dr Ste 1104
Lexington, KY 40505-9009
Phone
(859) 254-1035
Fax
(859) 254-2075
NPI assigned
Feb 9, 2007
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 255369 KY Primary

Addresses

Primary practice location

2250 Thunderstick Dr Ste 1104
Lexington, KY 40505-9009

Mailing address

2250 Thunderstick Dr Ste 1104
Lexington, KY 40505-9009
Phone (859) 254-1035

Other practice location 1

600 Old Frankfort Cir
Lexington, KY 40510-9689
Phone (859) 253-1686 ext. 520

Other identifiers 2

IdentifierTypeStateIssuer
30615058MedicaidKY
7100720920MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210628003541 KY Practitioner - Clinical Social Worker 4587065560 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
255369KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Counseling Center, LLC CurrentSince Oct 21, 2024 Accepting new patients

Locations

1169 Eastern Pkwy
Ste 3328
Louisville, KY 40217
Phone (205) 914-2526

1001 Gibson Bay Dr
Ste 201
Richmond, KY 40475

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1841331048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 THUNDERSTICK DR STE 1104",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405059009",
            "telephone_number": "859-254-1035",
            "fax_number": "859-254-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 THUNDERSTICK DR STE 1104",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405059009",
            "telephone_number": "859-254-1035",
            "fax_number": "859-254-2075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Old Frankfort Cir",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405109689",
            "country_code": "US",
            "telephone_number": "859-253-1686 x520",
            "fax_number": "859-254-2743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMBS",
        "first_name": "ANGELA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30615058",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100720920",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.