Individual provider Active NPI

Stephanie Renee Abernathy

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1912537572
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
259010 Issued in KY
Practice address
623 Southwestern Pkwy
Louisville, KY 40211-3209
Phone
(502) 963-7045
NPI assigned
Jan 23, 2020
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 259010 KY Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

623 Southwestern Pkwy
Louisville, KY 40211-3209

Mailing address

623 Southwestern Pkwy
Louisville, KY 40211-3209
Phone (502) 963-7045

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
259010KYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1912537572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 SOUTHWESTERN PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402113209",
            "telephone_number": "502-963-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 SOUTHWESTERN PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402113209",
            "telephone_number": "502-963-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABERNATHY",
        "first_name": "STEPHANIE",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "259010",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.