Individual provider Active NPI

Scout Burns, LCSW

  • Clinical Social Worker
  • Mishawaka, IN
National Provider Identifier
1568169019
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009928A Issued in IN
Practice address
451 Travers CT Apt D
Mishawaka, IN 46545-3745
Phone
(317) 514-3815
NPI assigned
Feb 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.024525 IL
Clinical Social Worker 1041C0700X 34009928A IN Primary

Addresses

Primary practice location

451 Travers CT Apt D
Mishawaka, IN 46545-3745

Mailing address

451 Travers CT Apt D
Mishawaka, IN 46545-3745

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
I20230519002035 IN Practitioner - Clinical Social Worker 3678939410 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.024525ILMDClinical Social Worker
34009928AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Health Inc Current Accepting new patients
Bowen Health Inc CurrentSince May 24, 2023 Accepting new patients

Locations

990 Illinois St
Plymouth, IN 46563
Phone (574) 936-9646

850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169

2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1568169019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 TRAVERS CT APT D",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 TRAVERS CT APT D",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453745",
            "telephone_number": "317-514-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "SCOUT",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024525",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009928A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.