Active NPI
Andrew Howard Proskin, LGSW
- Social Worker
- Fayetteville, WV
National Provider Identifier
1053192500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- BP00946692
- Practice address
- 322 Crooked Run Rd
Fayetteville, WV 25840-6745 - Phone
- (304) 890-3419
- NPI assigned
- Oct 11, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | BP00946692 | WV | Primary |
Addresses
Primary practice location
322 Crooked Run Rd
Fayetteville, WV 25840-6745
Mailing address
322 Crooked Run Rd
Fayetteville, WV 25840-6745
Phone (304) 890-3419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Cincinnati, OH 45263
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP00946692 | WV | MD | Social Worker |
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.
-
- Nurse Practitioner
- Charleston, WV
- NPI 1558743849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696982400000",
"number": "1053192500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 CROOKED RUN RD",
"city": "FAYETTEVILLE",
"state": "WV",
"postal_code": "258406745",
"telephone_number": "304-890-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 CROOKED RUN RD",
"city": "FAYETTEVILLE",
"state": "WV",
"postal_code": "258406745",
"telephone_number": "304-890-3419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROSKIN",
"first_name": "ANDREW",
"middle_name": "HOWARD",
"credential": "LGSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-11",
"last_updated": "2023-10-11",
"certification_date": "2023-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WV",
"license": "BP00946692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.