Individual provider Active NPI

Krystle M Working Drury, LCSW

  • Clinical Social Worker
  • Newburgh, IN
National Provider Identifier
1922384692
Registry record updated Jun 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006969A Issued in IN
Practice address
4466 State Route 261 Ste 1
Newburgh, IN 47630-2832
Phone
(812) 490-2100
NPI assigned
Oct 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6211 KY
Clinical Social Worker 1041C0700X 33006405A IN
Clinical Social Worker 1041C0700X 34006969A IN Primary

Addresses

Primary practice location

4466 State Route 261 Ste 1
Newburgh, IN 47630-2832

Mailing address

4466 State Route 261 Ste 1
Newburgh, IN 47630-2832
Phone (812) 490-2100

Other identifiers 3

IdentifierTypeStateIssuer
34006969AOtherINLCSW
7100514370MedicaidKY
254098OtherKYLCSW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210914002981 IN Practitioner - Clinical Social Worker 7315336328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anchored by Hope LLCGroup PAC ID 1456757558, 3 clinicians

Practice addresses (Care Compare)

4466 State Route 261
Suite 1
Newburgh, IN 47630-2832
Phone (812) 490-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6211KYMDMental Health Counselor
33006405AINMDClinical Social Worker
34006969AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anchored by Hope LLC CurrentSince Oct 1, 2021 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": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591488000000",
    "number": "1922384692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4466 STATE ROUTE 261 STE 1",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476302832",
            "telephone_number": "812-490-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 STATE ROUTE 261 STE 1",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476302832",
            "telephone_number": "812-490-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORKING DRURY",
        "first_name": "KRYSTLE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "6211",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "33006405A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006969A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "34006969A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100514370",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "254098",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.