Individual provider Active NPI

Zachary Kyle, MSW, LCSW

  • Clinical Social Worker
  • South Bend, IN
National Provider Identifier
1104294180
Registry record updated May 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008261A Issued in IN
Practice address
311 S Eddy St
South Bend, IN 46617-3201
Phone
(574) 213-2456
NPI assigned
Sep 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2026

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 34008261A IN Primary

Addresses

Primary practice location

311 S Eddy St
South Bend, IN 46617-3201

Mailing address

311 S Eddy St
South Bend, IN 46617-3201
Phone (574) 213-2456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH, KS3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190708001034 IN Practitioner - Clinical Social Worker 4789919176 Reassigns benefits to 2 organizations
I20210426001146 OH Practitioner - Clinical Social Worker 4789919176 Reassigns benefits to 1 organization
I20230726000192 KS Practitioner - Clinical Social Worker 4789919176 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crawford County Mental Health CenterGroup PAC ID 3072955616, 13 clinicians

Practice addresses (Care Compare)

911 E Centennial Dr
Crawford County Mental Health
Pittsburg, KS 66762-6601
Phone (620) 231-5130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Center, Inc CurrentSince Jun 26, 2023 Accepting new patients
Extended Care Specialists, Inc Counselor CurrentSince May 26, 2019 Accepting new patients
Crawford County Mental Health Center CurrentSince Nov 18, 2024 Accepting new patients
Everlasting Hills Counseling, LLC Clinical Current Accepting new patients
Northeastern Center Inc CurrentSince Jun 26, 2023 Accepting new patients
United Community Services, Inc. PastSince Feb 16, 2022 Accepting new patients
Extended Care Specialists, Inc Clinical PastSince Oct 6, 2024 Accepting new patients

Locations

833 E Main St
Albion, IN 46701
Phone (260) 636-6975

1800 Wesley Rd
Auburn, IN 46706
Phone (260) 925-2453

3512 Stellhorn Rd
Fort Wayne, IN 46815

220 S Main St
Kendallville, IN 46755
Phone (219) 347-4400

8398 Mississippi St
Fl 2
Merrillville, IN 46410

311 S Eddy St
South Bend, IN 46617
Phone (574) 213-2456

911 E Centennial Dr
Pittsburg, KS 66762
Phone (620) 338-7282

3958 Brown Park Dr
Ste D
Hilliard, OH 43026

Organizations & group practices 8

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778371200000",
    "number": "1104294180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173201",
            "telephone_number": "574-213-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173201",
            "telephone_number": "574-213-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "ZACHARY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2026-05-10",
        "certification_date": "2026-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008261A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.