Individual provider Active NPI

John R Michalowski, LCSW

  • Clinical Social Worker
  • Ridgway, PA
National Provider Identifier
1457437212
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW012585 Issued in PA
Practice address
9 S Mill Ave Apt 3
Ridgway, PA 15853-1043
Phone
(814) 594-6829
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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 CW012585 PA Primary

Addresses

Primary practice location

9 S Mill Ave Apt 3
Ridgway, PA 15853-1043

Mailing address

24 Metoxet St
Ridgway, PA 15853-1919
Phone (814) 903-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20061130000410 PA Practitioner - Clinical Social Worker 9638177546 Reassigns benefits to 1 organization
Practice locations: Ridgway, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickinson Center, IncGroup PAC ID 3870489131, 11 clinicians

Practice addresses (Care Compare)

43 Servidea Dr
Ridgway, PA 15853-6333
Phone (814) 766-2145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW012585PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dickinson Center, Inc CurrentSince Jan 20, 2020 Accepting new patients
Cen Clear Child Services, Inc. CurrentSince Aug 19, 2013 Accepting new patients

Locations

1001 E 2nd St
Coudersport, PA 16915
Phone (814) 274-7407

1 N Main St
Fl 3
Coudersport, PA 16915
Phone (814) 274-8651

43 Servidea Dr
Ridgway, PA 15853
Phone (814) 776-0225

808 S Michael St
Saint Marys, PA 15857
Phone (814) 834-9722

50 Bigler Rd
Woodland, PA 16881

Organizations & group practices 2

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1457437212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 METOXET ST",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158531919",
            "telephone_number": "814-903-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 S MILL AVE APT 3",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158531043",
            "telephone_number": "814-594-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALOWSKI",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgway, PA

Sources for this page

Verify at the official NPI Registry.