Active NPI
Melissa Interess, LCSW
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1548584725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34005769A
- Practice address
- 5162 E Stop 11 Rd
Suite 1
Indianapolis, IN 46237-8617 - Phone
- (617) 784-7762
- NPI assigned
- Mar 17, 2010
- Last updated
- Mar 17, 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 | 34005769A | IN | Primary |
Addresses
Primary practice location
5162 E Stop 11 Rd
Suite 1
Indianapolis, IN 46237-8617
Mailing address
211 E Beverly Dr
Indianapolis, IN 46205-1029
Phone (617) 784-7762
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200372510 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34005769A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268784000000",
"number": "1548584725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 E BEVERLY DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462051029",
"telephone_number": "617-784-7762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5162 E STOP 11 RD",
"address_2": "SUITE 1",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462378617",
"telephone_number": "617-784-7762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INTERESS",
"first_name": "MELISSA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-17",
"last_updated": "2010-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34005769A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200372510",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
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- International Medical Surgical Center, LLC
- International Physiotherapy Associates Professional Corporation
- Interval Therapy & Consultation
- Intouch Christian Counseling, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.