Individual provider Active NPI

Wendy James, MSW LCSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1205153087
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006096A Issued in IN
Practice address
1 N Barker Ave
Evansville, IN 47712-5601
Phone
(812) 423-4419
Fax
(812) 422-7558
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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 34006096A IN Primary

Addresses

Primary practice location

1 N Barker Ave
Evansville, IN 47712-5601

Mailing address

415 Mulberry Street
Evansville, IN 47713-1230
Phone (812) 423-7791

Other identifiers 3

IdentifierTypeStateIssuer
000000689447OtherINANTHEM
100240880MedicaidIN
12162195OtherINCAQH

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
I20101206000161 IN Practitioner - Clinical Social Worker 5597952440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

414 SE 4TH St
Suite 101
Evansville, IN 47713-1219
Phone (812) 428-4880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Behavioral Healthcare, Inc. CurrentSince Oct 22, 2010 Accepting new patients
Southwestern Behavioral Healthcare, Inc. CurrentSince Oct 22, 2010 Accepting new patients

Locations

414 SE 4th St
Ste 101
Evansville, IN 47713
Phone (812) 424-4880

415 Mulberry St
Evansville, IN 47713
Phone (812) 436-4232

1 N Barker Ave
Evansville, IN 47712
Phone (812) 423-4418

309 N Sawmill St
Mount Vernon, IN 47620
Phone (812) 383-6558

Organizations & group practices 2

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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1205153087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MULBERRY STREET",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131230",
            "telephone_number": "812-423-7791",
            "fax_number": "812-422-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N BARKER AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477125601",
            "telephone_number": "812-423-4419",
            "fax_number": "812-422-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "WENDY",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006096A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000689447",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100240880",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12162195",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.