Lora A Klompmaker, MSW, LSW
Individual provider Active NPI Social Worker · Lowell, IN
NPI 1699349993 · NPPES record last updated May 19, 2021
Key facts
- NPI
- 1699349993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 33009409A (IN)
- Practice address
- 2068 Lucas Pkwy
Lowell, IN 46356-2169 - Phone
- (219) 690-7025
- NPI assigned
- May 19, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240122000534 | IN | Practitioner - Clinical Social Worker | 7810349230 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33009409A | IN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Current |
Accepting new patients | |
| Wings Wellness LLC | Social Worker | Current | 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
17640 Morse St
Lowell, IN 46356
Phone (219) 462-6866
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 33009409A | IN | Yes |
Addresses
Primary practice location
2068 Lucas Pkwy
Lowell, IN 46356-2169
Mailing address
17474 Hoshaw St
Lowell, IN 46356-9350
Phone (219) 776-4774
Other providers in Lowell, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.