Individual provider Active NPI

Marcia Loving-Wilkerson, LCSW

  • Clinical Social Worker
  • Vincennes, IN
National Provider Identifier
1740865419
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34011409A Issued in IN
Practice address
515 Bayou St
Vincennes, IN 47591-1034
Phone
(812) 886-6800
Fax
(812) 886-6809
NPI assigned
Mar 15, 2021
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33009845A IN
Clinical Social Worker 1041C0700X 34011409A IN Primary

Addresses

Primary practice location

515 Bayou St
Vincennes, IN 47591-1034

Mailing address

PO Box 556
Vincennes, IN 47591-0556
Phone (812) 494-9501

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
I20240920000718 IN Practitioner - Clinical Social Worker 1052852886 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33009845AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Family Health Center, Inc. CurrentSince Sep 4, 2024 Accepting new patients
Good Samaritan Family Health Center, Inc CurrentSince Sep 4, 2024 Accepting new patients
Good Samaritan Family Health Center, Inc Past Accepting new patients
Good Samaritan Family Health Center, Inc Past Accepting new patients

Locations

1027 Washington Ave
Vincennes, IN 47591
Phone (812) 494-7500

1160 E Saint Clair St
Vincennes, IN 47591
Phone (812) 882-1064

300 N 1st St
Vincennes, IN 47591
Phone (812) 494-9510

515 Bayou St
Vincennes, IN 47591
Phone (812) 886-0907

Organizations & group practices 4

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": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1740865419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 556",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475910556",
            "telephone_number": "812-494-9501",
            "fax_number": "812-494-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 BAYOU ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911034",
            "telephone_number": "812-886-6800",
            "fax_number": "812-886-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVING-WILKERSON",
        "first_name": "MARCIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33009845A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34011409A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.