John W. George, LCSW, SWL,

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34000629A Issued in IN

Practice address

1015 Michigan Ave
Logansport, IN 46947-1526

Phone

(574) 722-5151

Fax

(574) 739-1414

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Four County Comprehensive Mental Health Center Inc 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Four County Comprehensive Mental Health Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Peru, IN
  • NPI 1972545945

  IN

  Medicare reassignment Care Compare group NPD
• Four County Comprehensive Mental Health Center, Inc

  • Psychiatric Hospital
  • Peru, IN
  • NPI 1457539751
  NPD

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1528099892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471526",
            "telephone_number": "574-722-5151",
            "fax_number": "574-739-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471526",
            "telephone_number": "574-722-5151",
            "fax_number": "574-739-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "JOHN",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "LCSW, SWL,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33000266A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000286A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000629A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000184322",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL",
            "identifier": "138835000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Rees Frieden, OD
• Jeryl Glynn Fullen, M.D.
• Brandy Garretson
• Liam Allen Gay, RBT
• Genoa Healthcare LLC
• Mallory Glassburn, BS
• John Courtney Glasson, BSW
• Tonya Goodspeed, MD
• Jack Everett Goris, D.D.S.
• Amber Michelle Gould

• All providers in Logansport, IN
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; 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.

Verify at the official NPI Registry.