Individual provider Active NPI

Michelle Ann Lynch, LMSW

  • Clinical Social Worker
  • Waterloo, IA
National Provider Identifier
1265922603
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006972 Issued in IA
Practice address
3251 W 9TH St
Waterloo, IA 50702-5310
Phone
(319) 234-2893
Fax
(319) 234-0354
NPI assigned
May 11, 2018
Last updated
May 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2018

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 006972 IA Primary

Addresses

Primary practice location

3251 W 9TH St
Waterloo, IA 50702-5310

Mailing address

3251 W 9TH St
Waterloo, IA 50702-5310
Phone (319) 234-2893

Other identifiers 1

IdentifierTypeStateIssuer
0074435MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20211012002608 IA Practitioner - Clinical Social Worker 3577961150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
83.66
Promoting interoperability
83
Improvement activities
40
Cost
69.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006972IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Memorial Hospital Corporation CurrentSince Oct 4, 2021 Accepting new patients
Allen Memorial Hospital Corporation CurrentSince Oct 4, 2021 Accepting new patients
Black Hawk-Grundy Mental Health Center Inc. PastSince Jul 1, 1990 Accepting new patients

Locations

164 W Dale St
Ste 6B
Waterloo, IA 50703

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1265922603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3251 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025310",
            "telephone_number": "319-234-2893",
            "fax_number": "319-234-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025310",
            "telephone_number": "319-234-2893",
            "fax_number": "319-234-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "006972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074435",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.