Organization Active NPI

Lena Embry LCSW LLC

  • Clinic/Center
  • Louisville, KY
National Provider Identifier
1922738285
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LENA EMBRY LCSW LLC
Practice address
4602 Southern Pkwy Ste 1D
Louisville, KY 40214-1429
Phone
(812) 491-1307
Fax
(928) 202-4458
NPI assigned
Jun 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Lena EmbryNPI 1073179370
Title
Owner
Phone
(928) 298-5100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4602 Southern Pkwy Ste 1D
Louisville, KY 40214-1429

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181

Other practice location 1

406 S 1st St
Camp Verde, AZ 86322
Phone (928) 298-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230614003936 KY Part B Supplier - Clinic/Group Practice 6901261239 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

4602 Southern Pkwy
Ste 1D
Louisville, KY 40214
Phone (502) 461-4111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1922738285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-492-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 SOUTHERN PKWY STE 1D",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402141429",
            "telephone_number": "812-491-1307",
            "fax_number": "928-202-4458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 S 1st St",
            "address_purpose": "LOCATION",
            "city": "Camp Verde",
            "state": "AZ",
            "postal_code": "86322",
            "country_code": "US",
            "telephone_number": "928-298-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LENA EMBRY LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-10",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "EMBRY",
        "authorized_official_first_name": "LENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-298-5100"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.