Individual provider Active NPI

Lynda Barrett Hargroves, LCSW

  • Professional Counselor
  • Johnson City, TN
National Provider Identifier
1922181817
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LSW0000003529 Issued in TN
Practice address
4132 Bristol Hwy
Parkside Center Suite 3
Johnson City, TN 37601-2932
Phone
(423) 952-4666
Fax
(276) 794-7965
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LSW0000003529 TN Primary

Addresses

Primary practice location

4132 Bristol Hwy
Parkside Center Suite 3
Johnson City, TN 37601-2932

Mailing address

PO Box 114
Bristol, TN 37621-0114
Phone (423) 952-4666

Other identifiers 1

IdentifierTypeStateIssuer
LSW0000003529OtherTNLCSW LICENSE NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20110419000643 TN Practitioner - Clinical Social Worker 2860677788 Practice locations: Johnson City, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4132 Bristol Hwy
Suite 3
Johnson City, TN 37601-3162

4132 Bristol Hwy 3
Johnson City, TN 37601-3162
Phone (423) 952-4666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW0000003529TNMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1922181817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 114",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376210114",
            "telephone_number": "423-952-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4132 BRISTOL HWY",
            "address_2": "PARKSIDE CENTER SUITE 3",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012932",
            "telephone_number": "423-952-4666",
            "fax_number": "276-794-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROVES",
        "first_name": "LYNDA",
        "middle_name": "BARRETT",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "LSW0000003529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE NO",
            "identifier": "LSW0000003529",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.