Individual provider Active NPI

Farah A Ali, MSW

  • Clinical Social Worker
  • Mishawaka, IN
National Provider Identifier
1790329068
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105935 Issued in TX
Practice address
1411 Lincolnway W
Mishawaka, IN 46544-1626
Phone
(574) 533-1234
Fax
(574) 537-2652
NPI assigned
Oct 30, 2019
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 105935 TX Primary

Addresses

Primary practice location

1411 Lincolnway W
Mishawaka, IN 46544-1626

Mailing address

PO Box 809
Goshen, IN 46527-0809
Phone (574) 533-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, TX, MN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220325001877 IN Practitioner - Clinical Social Worker 5799170890 Reassigns benefits to 1 organization
I20231011000895 TX Practitioner - Clinical Social Worker 5799170890 Reassigns benefits to 1 organization
I20240305001590 MN Practitioner - Clinical Social Worker 5799170890 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26915MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Jun 28, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646

2355 Highway 36 W
Ste 400
Saint Paul, MN 55113
Phone (612) 460-1597

3753 Howard Hughes Pkwy
Ste 200
Las Vegas, NV 89169
Phone (702) 919-6580

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 1

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": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1790329068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465270809",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 LINCOLNWAY W",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441626",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "FARAH",
        "middle_name": "A",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2024-02-13",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "105935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.