Individual provider Active NPI

Melissa J Beadle

  • Clinical Social Worker
  • Terre Haute, IN
National Provider Identifier
1689228942
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009511A Issued in IN
Practice address
619 Washington Ave
Terre Haute, IN 47802-1128
Phone
(812) 917-5006
NPI assigned
Jul 25, 2019
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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 34009511A IN Primary

Addresses

Primary practice location

619 Washington Ave
Terre Haute, IN 47802-1128

Mailing address

2704 Washington Ave Ste B
Vincennes, IN 47591-3667
Phone (812) 891-4053

Other practice location 1

2704 Washington Ave Ste B
Vincennes, IN 47591-3667
Phone (812) 891-4053

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
I20260223002703 IN Practitioner - Clinical Social Worker 7911488499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34009511AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Jan 27, 2026 Accepting new patients
Next Step Foundation Inc Social Worker PastSince Jul 28, 2019 Accepting new patients
SKM Therapy LLC Clinical PastSince Jun 15, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1689228942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 WASHINGTON AVE STE B",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475913667",
            "telephone_number": "812-891-4053",
            "fax_number": "812-790-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 WASHINGTON AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478021128",
            "telephone_number": "812-917-5006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2704 Washington Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "475913667",
            "country_code": "US",
            "telephone_number": "812-891-4053",
            "fax_number": "812-790-2307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEADLE",
        "first_name": "MELISSA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009511A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.