Individual provider Active NPI

Cheryl L Nussbaum, MSW, LSCSW

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1407953326
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSCSW 0857 Issued in KS
Practice address
3425 W Central Ave
Wichita, KS 67203-4919
Phone
(316) 650-8885
Fax
(316) 943-1139
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LSCSW 0857 KS Primary

Addresses

Primary practice location

3425 W Central Ave
Wichita, KS 67203-4919

Mailing address

547 N Roosevelt St
Wichita, KS 67208-3273
Phone (316) 684-5448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20250228002049 WA Practitioner - Clinical Social Worker 2769554807 Practice locations: Olympia, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3015 Moore St SE
Olympia, WA 98501-3578
Phone (316) 650-8885

315 Moore St SE
Olympia, WA 98501-3578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSCSW 0857KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ralph Bharati, MD, PA Clinical Past Accepting new patients

Organizations & group practices 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407953326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 N ROOSEVELT ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083273",
            "telephone_number": "316-684-5448",
            "fax_number": "316-684-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034919",
            "telephone_number": "316-650-8885",
            "fax_number": "316-943-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "CHERYL",
        "middle_name": "L",
        "credential": "MSW, LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "LSCSW 0857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.