Individual provider Active NPI

Susan Alexandra Cliburn Arnold, LCSW

  • Clinical Social Worker
  • Danville, KY
National Provider Identifier
1881013605
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
252942 Issued in KY
Practice address
410 W Broadway St
Danville, KY 40422-1420
Phone
(304) 654-9390
NPI assigned
Apr 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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 6013 KY
Clinical Social Worker 1041C0700X 252942 KY Primary

Addresses

Primary practice location

410 W Broadway St
Danville, KY 40422-1420

Mailing address

410 W Broadway St
Danville, KY 40422-1420
Phone (304) 654-9390

Other identifiers 1

IdentifierTypeStateIssuer
1790731081MedicaidKY

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
I20171129001888 KY Practitioner - Clinical Social Worker 6406113489 Practice locations: Danville, KY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

410 W Broadway St
Danville, KY 40422-1420
Phone (304) 654-9390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6013KYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Leslie Ferguson , PLLC Past Accepting new patients

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1881013605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W BROADWAY ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221420",
            "telephone_number": "304-654-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W BROADWAY ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221420",
            "telephone_number": "304-654-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIBURN ARNOLD",
        "first_name": "SUSAN",
        "middle_name": "ALEXANDRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "6013",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "252942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

Verify at the official NPI Registry.