Individual provider Active NPI

Olga Goloschokin, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1043601610
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006965A Issued in IN
Practice address
8320 Madison Ave
Indianapolis, IN 46227-6066
Phone
(317) 888-5122
Fax
(317) 888-8642
NPI assigned
Feb 18, 2015
Last updated
Feb 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34006965A IN Primary

Addresses

Primary practice location

8320 Madison Ave
Indianapolis, IN 46227-6066

Mailing address

8320 Madison Ave
Indianapolis, IN 46227-6066
Phone (317) 888-5122

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
I20150424000631 IN Practitioner - Clinical Social Worker 2163741174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Indiana Medical College, School of Medicine of Purdue University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8320 Madison Ave
Indianapolis, IN 46227-6066
Phone (317) 882-5122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adult and Child Mental Health Center Inc CurrentSince Mar 9, 2015 Accepting new patients
Adult and Child Mental Health Center Inc CurrentSince Mar 9, 2015 Accepting new patients

Locations

1860 Northwood Plz
Franklin, IN 46131
Phone (317) 346-2000

8320 Madison Ave
Indianapolis, IN 46227
Phone (317) 381-5252

Interoperability endpoints

  • Direct secure messaging: olga.goloschokin.p1@direct.adultandchild.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1043601610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-888-5122",
            "fax_number": "317-888-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-888-5122",
            "fax_number": "317-888-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOSCHOKIN",
        "first_name": "OLGA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006965A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.