Individual provider Active NPI

Connie Jennie Lynn Hawley, LCSW

  • Clinical Social Worker
  • Richmond, IN
National Provider Identifier
1417242355
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007549A Issued in IN
Practice address
2000 Wernle Rd RM B6
Richmond, IN 47374-7015
Phone
(765) 288-1928
Fax
(765) 741-0335
NPI assigned
Jun 17, 2011
Last updated
May 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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 34007549A IN Primary

Addresses

Primary practice location

2000 Wernle Rd RM B6
Richmond, IN 47374-7015

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

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
I20160531001369 IN Practitioner - Clinical Social Worker 6709176993 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp. CurrentSince May 26, 2016 Accepting new patients
Meridian Health Services Corp CurrentSince May 26, 2016 Accepting new patients
Meridian Health Services Corp Past Accepting new patients
Meridian Health Services Corp Past Accepting new patients

Locations

240 N Tillotson Ave
Muncie, IN 47304

2000 Wernle Rd
Rm B6
Richmond, IN 47374
Phone (765) 966-2506

520 S 9th St
Ste A
Richmond, IN 47374
Phone (765) 254-5347

Interoperability endpoints

  • Direct secure messaging: connie.hawley.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 4

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": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1417242355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WERNLE RD RM B6",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473747015",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWLEY",
        "first_name": "CONNIE",
        "middle_name": "JENNIE LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007549A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.