Individual provider Active NPI

L D Lumpkin, LCSW LISAC

  • Clinical Social Worker
  • Lake Havasu City, AZ
National Provider Identifier
1922023621
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4026LCSW Issued in AZ
Practice address
1695 Mesquite Ave
Ste 216
Lake Havasu City, AZ 86403-5688
Phone
(928) 453-0404
Fax
(928) 855-2778
NPI assigned
Jul 13, 2006
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11050 AZ
Clinical Social Worker 1041C0700X 4026LCSW AZ Primary

Addresses

Primary practice location

1695 Mesquite Ave
Ste 216
Lake Havasu City, AZ 86403-5688

Mailing address

1695 Mesquite Ave
Ste 216
Lake Havasu City, AZ 86403-5688
Phone (928) 453-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040916001097 AZ Practitioner - Clinical Social Worker 6709853880 Reassigns benefits to 1 organization
Practice locations: Lake Havasu City, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Havasu Behavioral Health LLCGroup PAC ID 3971945767, 2 clinicians

Practice addresses (Care Compare)

1695 Mesquite Ave
Suite 216
Lake Havasu City, AZ 86403-5688
Phone (928) 453-0404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11050AZMDAddiction (Substance Use Disorder) Counselor
4026LCSWAZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Havasu Behavioral Health, LLC Clinical CurrentSince Oct 1, 2007 Accepting new patients

Locations

1695 Mesquite Ave
Ste 216
Lk Havasu Cty, AZ 86403
Phone (928) 453-0404

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1922023621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 MESQUITE AVE",
            "address_2": "STE 216",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035688",
            "telephone_number": "928-453-0404",
            "fax_number": "928-855-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 MESQUITE AVE",
            "address_2": "STE 216",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035688",
            "telephone_number": "928-453-0404",
            "fax_number": "928-855-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMPKIN",
        "first_name": "L D",
        "credential": "LCSW LISAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "11050",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "4026LCSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.