Individual provider Active NPI

Catherine Dywan, LCSW

  • Clinical Social Worker
  • Winamac, IN
National Provider Identifier
1770839797
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007415A Issued in IN
Practice address
540 Hospital Dr
Winamac, IN 46996
Phone
(574) 946-2194
NPI assigned
Jul 27, 2012
Last updated
Mar 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34007415A IN Primary
Clinical Social Worker 1041C0700X 149016947 IL

Addresses

Primary practice location

540 Hospital Dr
Winamac, IN 46996

Mailing address

PO Box 279
Winamac, IN 46996-0279
Phone (574) 946-2147

Other practice location 1

1015 Michigan Ave
Logansport, IN 46947-1526
Phone (574) 722-5151

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
I20160125001134 IN Practitioner - Clinical Social Worker 1355563248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulaski Memorial HospitalGroup PAC ID 3173515509, 45 clinicians

Practice addresses (Care Compare)

540 Hospital Dr
Winamac, IN 46996-1173
Phone (574) 946-2194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149016947ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pulaski Memorial Hospital CurrentSince Oct 28, 2019 Accepting new patients
Pulaski Memorial Hospital CurrentSince Oct 28, 2019 Accepting new patients

Locations

414 Lane St
North Judson, IN 46366
Phone (574) 896-2257

540 Hospital Dr
Winamac, IN 46996
Phone (574) 935-4327

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

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, 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": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1770839797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "WINAMAC",
            "state": "IN",
            "postal_code": "469960279",
            "telephone_number": "574-946-2147",
            "fax_number": "574-946-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 HOSPITAL DR",
            "city": "WINAMAC",
            "state": "IN",
            "postal_code": "46996",
            "telephone_number": "574-946-2194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Logansport",
            "state": "IN",
            "postal_code": "469471526",
            "country_code": "US",
            "telephone_number": "574-722-5151",
            "fax_number": "574-739-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYWAN",
        "first_name": "CATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-27",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007415A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016947",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winamac, IN

Sources for this page

Verify at the official NPI Registry.