Individual provider Active NPI

Serena A Feller, LCSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1952702979
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007991A Issued in IN
Practice address
977 S Kenmore Dr
Evansville, IN 47714-7514
Phone
(812) 480-8307
NPI assigned
Sep 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33007239A IN
Clinical Social Worker 1041C0700X 34007991A IN Primary

Addresses

Primary practice location

977 S Kenmore Dr
Evansville, IN 47714-7514

Mailing address

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

Other practice location 1

1110 Professional Blvd Ste A
Evansville, IN 47714-8000
Phone (812) 848-2322

Other identifiers 1

IdentifierTypeStateIssuer
200238820MedicaidIN

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
I20180308002651 IN Practitioner - Clinical Social Worker 9537420443 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

977 S Kenmore Dr
Evansville, IN 47714-7514
Phone (812) 916-0434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33007239AINMDSocial Worker
34007991AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Virtual Consult MD LLC CurrentSince Mar 1, 2020 Accepting new patients
Find Your Rhythm Counseling, LLC CurrentSince Aug 10, 2022 Accepting new patients
Luzio & Associates Behavioral Services, Inc. Social Worker PastSince Oct 26, 2018 Accepting new patients

Locations

1110 Professional Blvd
#A
Evansville, IN 47714
Phone (845) 397-7787

977 S Kenmore Dr
Evansville, IN 47714
Phone (812) 480-8307

5444 E Indiana St
Evansville, IN 47715
Phone (812) 435-9099

109 US Highway 66 E
Ste 151
Tell City, IN 47586
Phone (812) 727-4778

Organizations & group practices 3

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": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1952702979",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 S KENMORE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147514",
            "telephone_number": "812-480-8307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 Professional Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477148000",
            "country_code": "US",
            "telephone_number": "812-848-2322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELLER",
        "first_name": "SERENA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-09",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33007239A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007991A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200238820",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.