MEDICARE: MICHAEL JOSEPH LUMPKIN

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	104100000X	Social Worker	33013796A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CSW00001367	OTHER	KY	CERTIFIED SOCIAL WORKER
2	33013796A	OTHER	IN	LICENSED SOCIAL WORKER

General Provider Information

NPI Number	:	1770415358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOSEPH LUMPKIN

Provider Business Mailing Address
First Line	:	8005 CASTLEWAY DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-1946
Country	:	US
Telephone Number	:	463-202-1442
Fax Number	:

Provider Business Practice Location Address
First Line	:	8005 CASTLEWAY DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-1946
Country	:	US
Telephone Number	:	463-202-1442
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2026
Last Update Date	:	05/30/2026

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