Individual provider Active NPI

Joel William Kern, LCSW

  • Clinical Social Worker
  • Goshen, IN
National Provider Identifier
1124491980
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007795A Issued in IN
Practice address
2318 Nature View CT
Goshen, IN 46526-1557
Phone
(574) 538-9602
NPI assigned
Nov 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.017822 IL
Clinical Social Worker 1041C0700X 34007795A IN Primary

Addresses

Primary practice location

2318 Nature View CT
Goshen, IN 46526-1557

Mailing address

2318 Nature View CT
Goshen, IN 46526-1557
Phone (574) 538-9602

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
I20180221002239 IN Practitioner - Clinical Social Worker 8022379791 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

Practice addresses (Care Compare)

302 S Main St
Goshen, IN 46526-3725
Phone (574) 213-2331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017822ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Pointe LLC CurrentSince Sep 1, 2023 Accepting new patients
Joel William Counseling LLC Clinical CurrentSince Aug 15, 2024 Accepting new patients
Lincoln Counseling, PC Clinical PastSince Mar 30, 2022 Accepting new patients

Locations

302 S Main St
Goshen, IN 46526
Phone (574) 213-2331

113 Lincolnway E
Mishawaka, IN 46544
Phone (574) 255-4976

1001 N Hickory Rd
Ste 3
South Bend, IN 46615
Phone (574) 232-3100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24035/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1124491980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 NATURE VIEW CT",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261557",
            "telephone_number": "574-538-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2318 NATURE VIEW CT",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261557",
            "telephone_number": "574-538-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "JOEL",
        "middle_name": "WILLIAM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-02",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017822",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007795A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.