Individual provider Active NPI

Jeffrey Allen Wisniewski, LCSW

  • Clinical Social Worker
  • Monroeville, PA
National Provider Identifier
1104591130
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW024379 Issued in PA
Practice address
244 Center Rd Ste 301
Monroeville, PA 15146-1789
Phone
(412) 256-8256
Fax
(888) 971-4394
NPI assigned
Aug 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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 CW024379 PA Primary

Addresses

Primary practice location

244 Center Rd Ste 301
Monroeville, PA 15146-1789

Mailing address

244 Center Rd Ste 301
Monroeville, PA 15146-1789
Phone (412) 256-8256

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
I20240214002308 PA Practitioner - Clinical Social Worker 4284078569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Center for Ocd and Anxiety, LLCGroup PAC ID 7113274853, 11 clinicians

Practice addresses (Care Compare)

244 Ctr Rd
Suite 301
Monroeville, PA 15146-1789
Phone (412) 256-8256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Ocd and Anxiety, LLC Clinical CurrentSince Feb 1, 2024 Accepting new patients

Locations

244 Center Rd
Ste 301
Monroeville, PA 15146
Phone (412) 256-8256

1121 Boyce Rd
Ste 2100
Pittsburgh, PA 15241
Phone (412) 256-8256

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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1104591130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 CENTER RD STE 301",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151461789",
            "telephone_number": "412-256-8256",
            "fax_number": "888-971-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 CENTER RD STE 301",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151461789",
            "telephone_number": "412-256-8256",
            "fax_number": "888-971-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-11",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW024379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.