Individual provider Active NPI

Demetris Yvette Cole, MSW, LCSW

  • Clinical Social Worker
  • Munster, IN
National Provider Identifier
1770147340
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008304A Issued in IN
Practice address
720 45TH St
Munster, IN 46321-2818
Phone
(219) 852-2513
Fax
(219) 852-2443
NPI assigned
Apr 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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 34008304A IN Primary

Addresses

Primary practice location

720 45TH St
Munster, IN 46321-2818

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

6049 Broadway
Merrillville, IN 46410
Phone (219) 756-1500

Other practice location 2

24 Joliet St
Dyer, IN 46311-1705
Phone (219) 322-5747

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dcole486400@Direct.FranciscanAlliance.org Direct

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
I20191120001667 IN Practitioner - Clinical Social Worker 3779915368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

24 Joliet St
Dyer, IN 46311-1705
Phone (219) 864-2059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34008304AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Nov 4, 2019 Accepting new patients
Franciscan Physician Network CurrentSince Nov 4, 2019 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

720 45th St
Munster, IN 46321
Phone (219) 852-2513

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: dcole486400@direct.franciscanalliance.org

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1770147340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 45TH ST",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212818",
            "telephone_number": "219-852-2513",
            "fax_number": "219-852-2443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6049 Broadway",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "46410",
            "country_code": "US",
            "telephone_number": "219-756-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Joliet St",
            "address_purpose": "LOCATION",
            "city": "Dyer",
            "state": "IN",
            "postal_code": "463111705",
            "country_code": "US",
            "telephone_number": "219-322-5747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "DEMETRIS",
        "middle_name": "YVETTE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008304A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcole486400@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "720 45th St",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463212818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.