Active NPI
Pamela Jean Stopczynski, LCSW
- Clinical Social Worker
- Mishawaka, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34004027A
- Practice address
- 611 E Douglas Rd
Suite 405
Mishawaka, IN 46545-1464 - Phone
- (574) 335-6392
- NPI assigned
- Mar 6, 2007
- Last updated
- Jun 10, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34004027A | IN | Primary |
Addresses
Primary practice location
611 E Douglas Rd
Suite 405
Mishawaka, IN 46545-1464
Mailing address
23077 Brick Rd
South Bend, IN 46628-9720
Phone (574) 274-9174
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
755 W Carmel Dr
Suite 209
Carmel, IN 46032-5878
Phone (855) 284-7483
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34004027A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Current | Accepting new patients |
Locations
755 W Carmel Dr
Ste 209
Carmel, IN 46032
Phone (702) 372-2446
250 Main St
Ste 420
Lafayette, IN 47901
Phone (219) 885-3441
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
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, 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": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276128000000",
"number": "1457481848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23077 BRICK RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466289720",
"telephone_number": "574-274-9174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 E DOUGLAS RD",
"address_2": "SUITE 405",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465451464",
"telephone_number": "574-335-6392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOPCZYNSKI",
"first_name": "PAMELA",
"middle_name": "JEAN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2010-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34004027A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.