Individual provider Active NPI

Dana Fedorchak, LSW

  • Social Worker
  • Valparaiso, IN
National Provider Identifier
1730608159
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
33008808A Issued in NU
Practice address
607 Lincolnway
Valparaiso, IN 46383
Phone
(219) 548-8727
NPI assigned
Sep 18, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Social Worker 104100000X 33008808A NU Primary

Addresses

Primary practice location

607 Lincolnway
Valparaiso, IN 46383

Mailing address

292 E 129TH PL
Crown Point, IN 46307-7861
Phone (219) 308-5108

Other practice location 1

910 Michigan Ave
LA Porte, IN 46350-3505
Phone (219) 548-8727

Other practice location 2

2424 Franklin St
Michigan City, IN 46360-4562
Phone (219) 548-8727

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

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730608159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 E 129TH PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077861",
            "telephone_number": "219-308-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 LINCOLNWAY",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383",
            "telephone_number": "219-548-8727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463503505",
            "country_code": "US",
            "telephone_number": "219-548-8727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2424 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Michigan City",
            "state": "IN",
            "postal_code": "463604562",
            "country_code": "US",
            "telephone_number": "219-548-8727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDORCHAK",
        "first_name": "DANA",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": "33008808A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.