MR. RANDY A HULTBERG (LCSW) – Clinical Social Worker, NPI 1104846575

MR. RANDY A HULTBERG (LCSW) is a healthcare provider. based in Greenville, Kentucky. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. LSW0000000611 (TN). The NPI Number for MR. RANDY A HULTBERG (LCSW) is 1104846575

Main info

Male
Sole Proprietor
46 Years Of Experience
Accepts Medicare Assignment
Name
MR. RANDY A HULTBERG (LCSW)
NPI
1104846575
Phone
(270) 338-5211
Address
506 HOPKINSVILLE ST
Enumeration Date
20 July 2006
Last Update Date
6 May 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2703385211
Graduation Year
1980 (46 years ago)
PAC ID
3476618323
Group Practice PAC ID
8820902638
Professional Enrollment ID
I20101123000787
Address ID
KY423451104GR506XXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

1,195 CLINICAL SOCIAL WORKER in KY

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Provider Addresses for MR. RANDY A HULTBERG (LCSW)

  • 506, Hopkinsville Street, Greenville, Muhlenberg County, Kentucky, 42345, United States

    GREENVILLE, KY 423451104

    Phone: (270) 338-5211

    Fax: (270) 338-1624

    Type: Location

  • 735 North Dr

    Hopkinsville, KY 422402620

    Phone: (270) 886-5163

    Fax: (270) 886-5178

    Type: Location

  • PO BOX 614

    HOPKINSVILLE, KY 422410614

    Phone: (270) 886-2205

    Fax: (270) 886-0392

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-11-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090210000488IClinical Social WorkerTNTBD
I20101123000787IClinical Social WorkerKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90832Psychotherapy, 30 minutes28535$0
View full utilization report →

Insurance plans in this area (ZIP 42345)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820902638View full group profile
NameSpecialtyState
Clinical Social WorkerKY
Clinical Social WorkerKY
P S Y C H I A T R YKY
-KY
Clinical PsychologistKY
Nurse PractitionerKY
-KY
Nurse PractitionerKY
-KY
Clinical Social WorkerKY

Reviews

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Frequently asked questions

What identifier follows MR. RANDY A HULTBERG (LCSW) across health systems?
The NPI 1104846575 uniquely identifies MR. RANDY A HULTBERG (LCSW) in U.S. healthcare data.
Is MR. RANDY A HULTBERG (LCSW) currently accepting referrals based on NPI status?
Registry metadata lists MR. RANDY A HULTBERG (LCSW) as active.
What type of care does MR. RANDY A HULTBERG (LCSW) provide?
MR. RANDY A HULTBERG (LCSW)'s profile centers on Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MR. RANDY A HULTBERG (LCSW)?
MR. RANDY A HULTBERG (LCSW) is associated with Greenville, Kentucky in the same public data insurers reference.
Who maintains MR. RANDY A HULTBERG (LCSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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