Individual provider Active NPI

Mary Beth Schramlin, L.C.S.W.

  • Clinical Social Worker
  • La Porte, IN
National Provider Identifier
1295811743
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34000705A Issued in IN
Practice address
2364 N US Highway 35
La Porte, IN 46350-8380
Phone
(219) 325-3583
Fax
(219) 324-3583
NPI assigned
Oct 27, 2006
Last updated
Jan 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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 34000705A IN Primary

Addresses

Primary practice location

2364 N US Highway 35
La Porte, IN 46350-8380

Mailing address

2364 N US Highway 35
La Porte, IN 46350-8380
Phone (219) 325-3583

Other identifiers 1

IdentifierTypeStateIssuer
000000195562OtherINANTHEM BC/BS

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
I20110314000449 IN Practitioner - Clinical Social Worker 3375725211 Practice locations: La Porte, IN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2626 N State Rd 39
Suite 4
La Porte, IN 46350-2074
Phone (219) 325-3583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34000705AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1295811743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 N US HIGHWAY 35",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463508380",
            "telephone_number": "219-325-3583",
            "fax_number": "219-324-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 N US HIGHWAY 35",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463508380",
            "telephone_number": "219-325-3583",
            "fax_number": "219-324-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRAMLIN",
        "first_name": "MARY BETH",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000705A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000195562",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

Verify at the official NPI Registry.