Individual provider Active NPI

Lajeune Fredia Williams, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1770217515
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007739A Issued in IN
Practice address
6401 E Washington St
Indianapolis, IN 46219-6614
Phone
(317) 808-7085
NPI assigned
Jul 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 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 34007739A IN Primary

Addresses

Primary practice location

6401 E Washington St
Indianapolis, IN 46219-6614

Mailing address

PO Box 746720
Atlanta, GA 30374-6720
Phone (312) 733-9730

Other practice location 1

401 E 34th St
Indianapolis, IN 46205-3754
Phone (317) 926-1507

Other practice location 2

2201 S Weinbach Ave
Evansville, IN 47714-4209
Phone (812) 370-6003

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
I20220927001104 IN Practitioner - Clinical Social Worker 5294111373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Osh-in Physicians Group PCGroup PAC ID 6800100512, 62 clinicians

Practice addresses (Care Compare)

2201 S Weinbach Ave
Evansville, IN 47714-4209
Phone (812) 370-6003

5926 Crawfordsville Rd
B
Speedway, IN 46224-3722
Phone (317) 653-2730

6401 E Washington St
Indy Irvington Clinic
Indianapolis, IN 46219-6614
Phone (317) 808-7085

711 E 38TH St
Indianapolis, IN 46205-2748
Phone (463) 249-2314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34007739AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Raphael Health Center, Inc CurrentSince Aug 4, 2022 Accepting new patients
Osh-in Physicians Group, PC CurrentSince Apr 3, 2023 Accepting new patients
Raphael Health Center, Inc CurrentSince Aug 4, 2022 Accepting new patients
Oak Street Health Physicians Group, PC Past Accepting new patients

Locations

2201 S Weinbach Ave
Evansville, IN 47714
Phone (812) 370-6003

6401 E Washington St
Indianapolis, IN 46219
Phone (317) 662-3755

401 E 34th St
Indianapolis, IN 46205
Phone (317) 926-1507

5926 Crawfordsville Rd
#B
Speedway, IN 46224
Phone (317) 653-2730

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDCGDD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1770217515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746720",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746720",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 E WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196614",
            "telephone_number": "317-808-7085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E 34th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462053754",
            "country_code": "US",
            "telephone_number": "317-926-1507",
            "fax_number": "317-926-1508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 S Weinbach Ave",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477144209",
            "country_code": "US",
            "telephone_number": "812-370-6003",
            "fax_number": "812-901-6626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LAJEUNE",
        "middle_name": "FREDIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007739A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.