Individual provider Active NPI

Bennett C Nott, LCSW

  • Clinical Social Worker
  • Michigan City, IN
National Provider Identifier
1710077508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34000967 Issued in IN
Practice address
2814 Franklin St
Michigan City, IN 46360-6140
Phone
(219) 872-1500
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 34000967 IN Primary

Addresses

Primary practice location

2814 Franklin St
Michigan City, IN 46360-6140

Mailing address

PO Box 8852
Michigan City, IN 46361-8852
Phone (219) 872-1500

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
I20070807000723 IN Practitioner - Clinical Social Worker 0446341366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Counseling Centers, IncGroup PAC ID 2062463185, 5 clinicians

Practice addresses (Care Compare)

340 Commerce SQ
Michigan City, IN 46360-3374
Phone (219) 879-3283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34000967INMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Centers, Inc CurrentSince Aug 4, 2007 Accepting new patients
Nasr Psychiatric Services, P.C. PastSince Apr 1, 1990 Accepting new patients

Locations

340 Commerce Sq
Michigan City, IN 46360
Phone (219) 879-3283

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710077508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8852",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463618852",
            "telephone_number": "219-872-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606140",
            "telephone_number": "219-872-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTT",
        "first_name": "BENNETT",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.