Individual provider Active NPI

Rosetta Maria Deloof-Primmer, LCSW

  • Clinical Social Worker
  • Michigan City, IN
National Provider Identifier
1063751790
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
450 Saint John Rd
Michigan City, IN 46360-7354
Phone
(219) 879-0676
NPI assigned
Jan 31, 2013
Last updated
May 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 34006887A IN
Social Worker 104100000X 33006230A IN
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

450 Saint John Rd
Michigan City, IN 46360-7354

Mailing address

8239 E Walnut RDG
New Carlisle, IN 46552-9075
Phone (574) 276-9571

Other identifiers 1

IdentifierTypeStateIssuer
100163580AMedicaidIN

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
I20140501000877 IN Practitioner - Clinical Social Worker 9931332723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meridian Health Services CorpGroup PAC ID 5597679845, 78 clinicians

Practice addresses (Care Compare)

1818 Went Ave
Suite a
Mishawaka, IN 46545-6482
Phone (765) 288-1928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34006887AINMDMental Health Counselor
33006230AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp. CurrentSince May 5, 2025 Accepting new patients
Meridian Health Services Corp CurrentSince May 5, 2025 Accepting new patients

Locations

1818 Went Ave
Ste A
Mishawaka, IN 46545
Phone (574) 254-0229

240 N Tillotson Ave
Muncie, IN 47304

Interoperability endpoints

  • Direct secure messaging: rosetta.deloofprimmer.p1@direct.meridianhs.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": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1063751790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8239 E WALNUT RDG",
            "city": "NEW CARLISLE",
            "state": "IN",
            "postal_code": "465529075",
            "telephone_number": "574-276-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SAINT JOHN RD",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607354",
            "telephone_number": "219-879-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOOF-PRIMMER",
        "first_name": "ROSETTA",
        "middle_name": "MARIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34006887A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33006230A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100163580A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.