Active NPI
G Darlene Radcliff, MSW LCSW
- Clinical Social Worker
- Mishawaka, IN
National Provider Identifier
1053482646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34005241A
- Practice address
- 113 Lincoln Way East
Mishawaka, IN 46544-2016 - Phone
- (574) 255-4976
- Fax
- (574) 255-1882
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34005241A | IN | Primary |
Addresses
Primary practice location
113 Lincoln Way East
Mishawaka, IN 46544-2016
Mailing address
113 Lincoln Way East
Mishawaka, IN 46544-2016
Phone (574) 255-4976
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000341228 | Other | IN | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34005241A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln Counseling, PC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200700800000",
"number": "1053482646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 LINCOLN WAY EAST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465442016",
"telephone_number": "574-255-4976",
"fax_number": "574-255-1882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 LINCOLN WAY EAST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465442016",
"telephone_number": "574-255-4976",
"fax_number": "574-255-1882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADCLIFF",
"first_name": "G",
"middle_name": "DARLENE",
"name_prefix": "Mrs.",
"credential": "MSW LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2008-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34005241A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000341228",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.