Individual provider Active NPI

Aqueelah S Haleem, LCSW

  • Clinical Social Worker
  • New Albany, IN
National Provider Identifier
1518319433
Registry record updated Jul 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007570A Issued in IN
Practice address
2871 Charlestown Rd
New Albany, IN 47150-1984
Phone
(812) 297-8222
NPI assigned
Jul 2, 2016
Last updated
Jul 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 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 34007570A IN Primary

Addresses

Primary practice location

2871 Charlestown Rd
New Albany, IN 47150-1984

Mailing address

2871 Charlestown Rd
New Albany, IN 47150-1984
Phone (812) 297-8222

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
I20160822001747 IN Practitioner - Clinical Social Worker 7911292529 Practice locations: Jeffersonville, IN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2871 Charlestown Rd
New Albany, IN 47150-1984

326 E Court Ave
Jeffersonville, IN 47130-3412
Phone (812) 297-8222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467417600000",
    "number": "1518319433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2871 CHARLESTOWN RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471501984",
            "telephone_number": "812-297-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2871 CHARLESTOWN RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471501984",
            "telephone_number": "812-297-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEEM",
        "first_name": "AQUEELAH",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-02",
        "last_updated": "2016-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007570A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.