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1538638515

NPI Code Detail

MEDICARE: LIONHEART TRAUMA SUPPORT SERVICES, LLC

MEDICARE: LIONHEART TRAUMA SUPPORT SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538638515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIONHEART TRAUMA SUPPORT SERVICES, LLC

Provider Business Mailing Address
First Line	:	3147 CUSTER DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4020
Country	:	US
Telephone Number	:	859-314-8786
Fax Number	:	859-479-1090

Provider Business Practice Location Address
First Line	:	3147 CUSTER DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4020
Country	:	US
Telephone Number	:	859-447-0855
Fax Number	:	859-479-1090

Authorized Official
Title or Position	:	OWNER
Name	:	KATHERINE L. PENNINGTON
Credential	:	LCSW
Telephone Number	:	859-314-8786

Provider Enumeration Date	:	11/19/2018
Last Update Date	:	01/12/2026

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Directions to “LIONHEART TRAUMA SUPPORT SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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