Individual provider Active NPI

Lindsey Radabaugh, LCSW

  • Clinical Social Worker
  • Dalton, GA
National Provider Identifier
1902469539
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005768 Issued in GA
Practice address
1414 Dug Gap Rd
Dalton, GA 30720-5007
Phone
(706) 279-0405
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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 CSW005768 GA Primary

Addresses

Primary practice location

1414 Dug Gap Rd
Dalton, GA 30720-5007

Mailing address

210 Emerald LN
Mineral Bluff, GA 30559-2927
Phone (770) 289-5528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200129003107 GA Practitioner - Clinical Social Worker 9234565839 Practice locations: Blue Ridge, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

40 Highland Cir
Blue Ridge, GA 30513-3602
Phone (770) 289-5528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005768GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Trail Therapeutic Services, LLC Clinical CurrentSince Oct 22, 2023 Accepting new patients
Family and Children First LLC PastSince Dec 21, 2021 Accepting new patients

Organizations & group practices 2

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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1902469539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 EMERALD LN",
            "city": "MINERAL BLUFF",
            "state": "GA",
            "postal_code": "305592927",
            "telephone_number": "770-289-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 DUG GAP RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307205007",
            "telephone_number": "706-279-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADABAUGH",
        "first_name": "LINDSEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.