Active NPI
Ellyn Kutch
- Social Worker
- Valparaiso, IN
National Provider Identifier
1568138196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 34009132A
- Practice address
- 2801 Bertholet Blvd Ste 301
Valparaiso, IN 46383-7959 - Phone
- (219) 477-9239
- NPI assigned
- Aug 23, 2021
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 34009132A | IN | Primary |
Addresses
Primary practice location
2801 Bertholet Blvd Ste 301
Valparaiso, IN 46383-7959
Mailing address
2801 Bertholet Blvd Ste 301
Valparaiso, IN 46383-7959
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
326 E US Hwy 30
Schererville, IN 46375-2654
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34009132A | IN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pillars of Wellness | Current | Accepting new patients |
Locations
326 E US Highway 30
Schererville, IN 46375
Phone (219) 323-3311
2501 Valley Dr
Valparaiso, IN 46383
Phone (219) 323-3311
Organizations & group practices 1
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.
-
- Psychologist
- Schererville, IN
- NPI 1588105225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667779200000",
"number": "1568138196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 BERTHOLET BLVD STE 301",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463837959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 BERTHOLET BLVD STE 301",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463837959",
"telephone_number": "219-477-9239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUTCH",
"first_name": "ELLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-23",
"last_updated": "2022-11-07",
"certification_date": "2022-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "34009132A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.