Individual provider Active NPI

Alen Melik-Adamyan, LCSW

  • Social Worker
  • Erie, PA
National Provider Identifier
1093064248
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CW021265 Issued in PA
Practice address
4320 Dexter Ave
Erie, PA 16504-2444
Phone
(814) 825-2930
NPI assigned
Sep 4, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CW021265 PA Primary

Addresses

Primary practice location

4320 Dexter Ave
Erie, PA 16504-2444

Mailing address

4320 Dexter Ave
Erie, PA 16504-2444
Phone (814) 825-2930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200929002294 PA Practitioner - Clinical Social Worker 2668891318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abcs of Building Better Lives LLCGroup PAC ID 9931367950, 16 clinicians

Practice addresses (Care Compare)

4320 Dexter Ave
Eric, PA 16504-2444
Phone (814) 825-2930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW021265PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Abcs of Building Better Lives LLC CurrentSince Aug 1, 2020 Accepting new patients

Locations

4320 Dexter Ave
Erie, PA 16504
Phone (814) 825-2930

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": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1093064248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 DEXTER AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165042444",
            "telephone_number": "814-825-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DEXTER AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165042444",
            "telephone_number": "814-825-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELIK-ADAMYAN",
        "first_name": "ALEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-04",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "CW021265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.