Active NPI
Abigail Chan, LCSW
- Clinical Social Worker
- Columbus, IN
National Provider Identifier
1710125489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34006468A
- Practice address
- 1531 13TH St
Columbus, IN 47201-1300 - Phone
- (812) 376-6501
- Fax
- (812) 331-6700
- NPI assigned
- Feb 3, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34006468A | IN | Primary |
Addresses
Primary practice location
1531 13TH St
Columbus, IN 47201-1300
Mailing address
550 S Adams St
Bloomington, IN 47403-2165
Phone (812) 333-6324
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34006468A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382400000000",
"number": "1710125489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 S ADAMS ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032165",
"telephone_number": "812-333-6324",
"fax_number": "812-331-6700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1531 13TH ST",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472011300",
"telephone_number": "812-376-6501",
"fax_number": "812-331-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "ABIGAIL",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-03",
"last_updated": "2013-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34006468A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.