Active NPI
Jay Hamkins Indik, LICSW
- Clinical Social Worker
- Northampton, MA
National Provider Identifier
1508920232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1029484
- Practice address
- 218 Crescent St
Northampton, MA 01060-2169 - Phone
- (413) 584-3743
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 1029484 | MA | Primary |
Addresses
Primary practice location
218 Crescent St
Northampton, MA 01060-2169
Mailing address
218 Crescent St
Northampton, MA 01060-2169
Phone (413) 584-3743
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1029484 | MA | MD | Clinical Social Worker |
| 103988 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508920232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "218 CRESCENT ST",
"city": "NORTHAMPTON",
"state": "MA",
"postal_code": "010602169",
"telephone_number": "413-584-3743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 CRESCENT ST",
"city": "NORTHAMPTON",
"state": "MA",
"postal_code": "010602169",
"telephone_number": "413-584-3743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INDIK",
"first_name": "JAY",
"middle_name": "HAMKINS",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1029484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northampton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.