Individual provider Active NPI

Rebecca Ann Bohn, MSW, LCSW

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1639797699
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34010343A Issued in IN
Practice address
7311B W Jefferson Blvd
Fort Wayne, IN 46804-6237
Phone
(260) 446-8709
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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 34010343A IN Primary

Addresses

Primary practice location

7311B W Jefferson Blvd
Fort Wayne, IN 46804-6237

Mailing address

7311B W Jefferson Blvd
Fort Wayne, IN 46804-6237
Phone (260) 446-8709

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
I20230510001129 IN Practitioner - Clinical Social Worker 9931565389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7311 A W Jefferson Blvd
Fort Wayne, IN 46804-6237
Phone (260) 446-8709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Compassionate Counseling Services, LLC CurrentSince Jan 21, 2023 Accepting new patients
Center for Neurobehavioral Services Inc PastSince Jul 1, 2020 Accepting new patients

Locations

7311B W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2311

3142 Mallard Cove Ln
Fort Wayne, IN 46804
Phone (260) 446-8709

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": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1639797699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7311B W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046237",
            "telephone_number": "260-446-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7311B W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046237",
            "telephone_number": "260-446-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHN",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010343A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.