Individual provider Active NPI

Marcus C Blanton-Schaedel, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1508693615
Registry record updated Sep 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34011375A Issued in IN
Practice address
1919 E 67TH St
Indianapolis, IN 46220-1215
Phone
(317) 378-9633
NPI assigned
Sep 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2024

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 34011375A IN Primary

Addresses

Primary practice location

1919 E 67TH St
Indianapolis, IN 46220-1215

Mailing address

1919 E 67TH St
Indianapolis, IN 46220-1215
Phone (317) 378-9633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241226000900 IN Practitioner - Clinical Social Worker 6406383827 Reassigns benefits to 2 organizations
I20250131001878 OR Practitioner - Clinical Social Worker 6406383827 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34011375AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Dec 31, 2024 Accepting new patients
One Sensible Solution LLC Clinical CurrentSince Oct 17, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

6038 N Keystone Ave
Indianapolis, IN 46220
Phone (317) 296-4914

6100 N Keystone Ave
Ste 420
Indianapolis, IN 46220
Phone (317) 296-4914

6100 N Keystone Ave
Ste 42
Indianapolis, IN 46220
Phone (317) 296-4914

9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646

6038 N Keystone Ave
#One
Indianapolis, IN 46220
Phone (317) 296-4914

10260 SW Greenburg Rd
Fl 4
Tigard, OR 97223
Phone (503) 405-9338

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": "1726272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726272000000",
    "number": "1508693615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E 67TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201215",
            "telephone_number": "317-378-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E 67TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201215",
            "telephone_number": "317-378-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANTON-SCHAEDEL",
        "first_name": "MARCUS",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-14",
        "last_updated": "2024-09-14",
        "certification_date": "2024-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34011375A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.