Individual provider Active NPI

Emma Kathleen Derheimer Niespodziany, LCSW

  • Clinical Social Worker
  • Carmel, IN
National Provider Identifier
1093429219
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34010099A Issued in IN
Practice address
10255 Commerce Dr
Carmel, IN 46032-7699
Phone
(260) 403-9129
NPI assigned
Jan 11, 2023
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34010099A IN Primary

Addresses

Primary practice location

10255 Commerce Dr
Carmel, IN 46032-7699

Mailing address

10432 Connaught Dr
Carmel, IN 46032-9645
Phone (260) 403-9129

Other identifiers 1

IdentifierTypeStateIssuer
300075639MedicaidIN

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
I20250625002548 IN Practitioner - Clinical Social Worker 9830601848 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34010099AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Evermore Therapy and Wellness Group LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

660 Patrick Pl
Brownsburg, IN 46112
Phone (260) 403-9129

10255 Commerce Dr
Ste 123
Carmel, IN 46032
Phone (765) 969-0450

130 E Epler Ave
Southport, IN 46227
Phone (317) 757-5016

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": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1093429219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10432 CONNAUGHT DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460329645",
            "telephone_number": "260-403-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10255 COMMERCE DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327699",
            "telephone_number": "260-403-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIESPODZIANY",
        "first_name": "EMMA",
        "middle_name": "KATHLEEN DERHEIMER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010099A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300075639",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.