Active NPI
Linda M Bauer, LCSW, BCD, CADC
- Clinical Social Worker
- Fort Wayne, IN
National Provider Identifier
1104857481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149-008185
- Practice address
- 2121 Lake Ave
Fort Wayne, IN 46805-5100 - Phone
- (260) 426-5431
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149-008185 | IL | Primary |
Addresses
Primary practice location
2121 Lake Ave
Fort Wayne, IN 46805-5100
Mailing address
12921 Indiana St
Grabill, IN 46741-9404
Phone (260) 426-5431
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149-008185 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364428800000",
"number": "1104857481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12921 INDIANA ST",
"city": "GRABILL",
"state": "IN",
"postal_code": "467419404",
"telephone_number": "260-426-5431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 LAKE AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468055100",
"telephone_number": "260-426-5431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "LINDA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LCSW, BCD, CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2013-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149-008185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.