Individual provider Active NPI

Jeremiah Robert Volk, LCSW-691

  • Clinical Social Worker
  • Casper, WY
National Provider Identifier
1083850440
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-691 Issued in WY
Practice address
500 S Wolcott St Ste 103
Casper, WY 82601-2882
Phone
(307) 333-5370
Fax
(307) 333-5371
NPI assigned
Jan 6, 2009
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/CenterGroup: 193200000X MULTI-SPECIALTY GROUP 261QR0405X LAT-356 WY
Clinical Social Worker 1041C0700X LCSW-691 WY Primary

Addresses

Primary practice location

500 S Wolcott St Ste 103
Casper, WY 82601-2882

Mailing address

500 S Wolcott St Ste 103
Casper, WY 82601-2882
Phone (307) 333-5370

Other practice location 1

1440 Wilkins Cir
Casper, WY 82601-1336
Phone (307) 237-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-691WYMDClinical Social Worker
LAT-356WYMDSubstance Use Disorder Rehabilitation Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Natrona County Behavioral Health 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, 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": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1083850440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S WOLCOTT ST STE 103",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012882",
            "telephone_number": "307-333-5370",
            "fax_number": "307-333-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S WOLCOTT ST STE 103",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012882",
            "telephone_number": "307-333-5370",
            "fax_number": "307-333-5371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1440 Wilkins Cir",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826011336",
            "country_code": "US",
            "telephone_number": "307-237-1800",
            "fax_number": "307-237-7126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOLK",
        "first_name": "JEREMIAH",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LCSW-691",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-06",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WY",
            "license": "LAT-356",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.