MR. RANDY A HULTBERG (NPI# 1104846575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104846575 |
| Entity Type | Individual |
| Full Name | MR. RANDY A HULTBERG |
| Credential | LCSW |
| Practice Address |
506 Hopkinsville St Greenville KY 42345-1104 |
| Mailing Address |
Po Box 614 Hopkinsville KY 42241-0614 |
| Practice Telephone | 2703385211 |
| Practice Fax Number | 2703381624 |
| Mailing Telephone | 2708862205 |
| Mailing Fax Number | 2708860392 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-05-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
804 | KY | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
LSW0000000611 | TN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 735 North Dr, Hopkinsville, KY 422402620 | 2708865163 | 2708865178 |
| Street Address |
506 HOPKINSVILLE ST |
| City | GREENVILLE |
| State | KY |
| Zip Code | 42345-1104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457993040 | Angela Maria Johnson | Counselor | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2019-10-15 |
| 1003319799 | Lindsay Calhoun | Counselor | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2018-03-09 |
| 1477060622 | Pamela Shelton | Counselor | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2018-01-09 |
| 1851808109 | Melissa Dukes | Peer Specialist | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2018-01-09 |
| 1952818593 | Allison Ducoff | Case Manager/Care Coordinator | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2018-01-04 |
| 1376079764 | Karla Brasher | Case Manager/Care Coordinator | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2017-05-04 |
| 1457808354 | Mark Allen Monroe Jr. | Social Worker | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2016-09-08 |
| 1437571460 | Sarah Ann Boyd | Counselor | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2014-01-10 |
| 1649511742 | Nora Wright | Counselor | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2013-03-14 |
| 1386973618 | Debbie Word | Counselor | 506 Hopkinsville St, Greenville, KY 42345-1104 | 2009-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669607917 | Felicia Wells | Speech-Language Pathologist | 515 Greene Drive, Greenville, KY 42345 | 2009-05-15 |
| 1992968085 | Roberta A Shelton | Occupational Therapist | 515 Green Drive, Greenville, KY 42345 | 2008-07-08 |
| 1659547503 | Kellyn Jones | Counselor | 506 W. Hopkinsville St, Greenville, KY 42345 | 2008-05-01 |
| 1922134956 | Guinn Shaw Cost Jr. | Family Medicine | 132 Sara's Lane, Greenville, KY 42345 | 2007-02-26 |
| 1205883949 | Katharine S Cox | Emergency Medicine | 504 Hopkinsville St, Greenville, KY 42345 | 2006-05-28 |
| 1265922447 | George Michael Garrett | Nurse Practitioner | 440 Hopkinsville St, Greenville, KY 42345 | 2018-05-14 |
| 1376088930 | Community Health Centers of Western Kentucky Inc | Social Worker | 226 Hopkinsville St, Greenville, KY 42345 | 2017-01-05 |
| 1982009585 | Kentucky Emergency I Services Psc | Physician Assistant | 440 Hopkinsville St, Greenville, KY 42345 | 2014-10-27 |
| 1538447016 | Christina N Buckley | Nurse Practitioner | 440 Hopkinsville St, Greenville, KY 42345 | 2011-08-01 |
| 1245542331 | James Derek Calhoun | Nurse Practitioner | 440 Hopkinsville St, Greenville, KY 42345 | 2010-07-06 |
| Find all providers in zip 42345 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841459 | Mickaella Ann Moser | Social Worker | 3030 Adams Blvd Apt 13, Greenville, NC 27858-4840 | 2020-11-04 |
| 1710596812 | Kiera Clemmons | Social Worker | 1611 Sandstone Ct, Greenville, NC 27834-0377 | 2020-07-24 |
| 1518584705 | Apriann Marchelle Sutton | Social Worker | 2050 Eastgate Dr., # E, Greenville, NC 27858 | 2020-07-03 |
| 1346870698 | From The Ground Up Wellness Center, LLC | Social Worker | 31 Smith Ave Unit 3, Greenville, RI 02828-1730 | 2020-01-24 |
| 1790324580 | Margaret Vester | Social Worker | 1502 E 4th St, Greenville, NC 27858-2609 | 2019-12-27 |
| 1003467267 | Martrell Denise Kelly John | Social Worker | 250 Commonwealth Dr, Greenville, SC 29615-4846 | 2019-09-27 |
| 1336790633 | Jenna Bonnell Canterbury | Social Worker | 926 Cleveland St Apt 4208, Greenville, SC 29601-4651 | 2019-09-27 |
| 1386294361 | Desirae Rivers | Social Worker | 132 Chandler Dr Apt B, Greenville, NC 27834-6075 | 2019-09-12 |
| 1770048365 | The Soar Firm, LLC | Social Worker | 2320 E North St Ste Gg8, Greenville, SC 29607-1247 | 2019-02-07 |
| 1447733068 | Kerri Lanzieri | Social Worker | 562 Putnam Pike, Greenville, RI 02828-2126 | 2018-09-10 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 42345 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.