Individual provider Active NPI

Kurtis O'Brien, LCSW

  • Clinical Social Worker
  • Fishers, IN
National Provider Identifier
1013320563
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007839A Issued in IN
Practice address
15448 Staffordshire Way
Fishers, IN 46037-4644
Phone
(765) 993-7473
NPI assigned
Jun 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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
Clinical Social Worker 1041C0700X 34007839A IN Primary

Addresses

Primary practice location

15448 Staffordshire Way
Fishers, IN 46037-4644

Mailing address

15448 Staffordshire Way
Fishers, IN 46037-4644
Phone (765) 993-7473

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
I20260205001435 IN Practitioner - Clinical Social Worker 3870072309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jane Pauley Community Health Center IncGroup PAC ID 7618152729, 77 clinicians

Practice addresses (Care Compare)

1315 N Arlington Ave
Indianapolis, IN 46219-3204
Phone (463) 232-7228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34007839AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jane Pauley Community Health Center Inc CurrentSince Jan 1, 2026 Accepting new patients
Cummins Behavioral Health Systems, Incorporated PastSince Apr 9, 2001 Accepting new patients

Locations

1503 N Mitthoefer Rd
Indianapolis, IN 46229

8931 E 30th St
Indianapolis, IN 46219
Phone (317) 355-9320

1315 N Arlington Ave
Indianapolis, IN 46219
Phone (317) 355-9334

1234 N Courtland Ave
Kokomo, IN 46901
Phone (765) 860-8365

Organizations & group practices 2

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1013320563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15448 STAFFORDSHIRE WAY",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374644",
            "telephone_number": "765-993-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15448 STAFFORDSHIRE WAY",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374644",
            "telephone_number": "765-993-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KURTIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-03",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007839A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.