Andrea Lynn Maltese, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34005719A Issued in IN

Practice address

600 N Jordan Ave
Caps #448
Bloomington, IN 47405-3190

Phone

(812) 855-5711

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1245330620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 W 17TH ST",
            "address_2": "SUITE B",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474043002",
            "telephone_number": "812-318-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N JORDAN AVE",
            "address_2": "CAPS #448",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053190",
            "telephone_number": "812-855-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTESE",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005719A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945018",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cacy Malone, RBT
• Destinee Malone, RBT-21-158532
• Richard K Malone, MD
• Megan Elizabeth Maloy Shepley
• Judy Lynn Malschick, MSW
• Abhinav Mandava
• Rachel D Manley, MD
• Cynthia Mann, FNP-C
• Nicole Mannia, LMHC
• Ross Manning, LCSW

• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.