Individual provider Active NPI

Joie Wroblewski

  • Addiction (Substance Use Disorder) Counselor
  • South Bend, IN
National Provider Identifier
1679988893
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
86000244A Issued in IN
Practice address
4218 W Western Ave
South Bend, IN 46619-2622
Phone
(574) 233-1524
Fax
(574) 233-1612
NPI assigned
Jun 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 86000244A IN Primary

Addresses

Primary practice location

4218 W Western Ave
South Bend, IN 46619-2622

Mailing address

4218 W Western Ave
South Bend, IN 46619-2622
Phone (574) 233-1524

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

LicenseStateTypeSpecialty
86000244AINMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Clinical Services II LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1679988893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4218 W WESTERN AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466192622",
            "telephone_number": "574-233-1524",
            "fax_number": "574-233-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4218 W WESTERN AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466192622",
            "telephone_number": "574-233-1524",
            "fax_number": "574-233-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WROBLEWSKI",
        "first_name": "JOIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "86000244A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.