Individual provider Active NPI

Danelle Jean King, MSW, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1811747058
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007543A Issued in IN
Practice address
3054 Ruckle St
Indianapolis, IN 46205-3968
Phone
(317) 796-1797
NPI assigned
Mar 22, 2024
Last updated
Mar 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 34007543A IN
Mental Health Counselor 101YM0800X 34007543A IN
Professional Counselor 101YP2500X 34007543A IN
Social Worker 104100000X 34007543A IN
Clinical Social Worker 1041C0700X 34007543A IN Primary
Marriage & Family Therapist 106H00000X 34007543A IN

Addresses

Primary practice location

3054 Ruckle St
Indianapolis, IN 46205-3968

Mailing address

3054 Ruckle St
Indianapolis, IN 46205-3968
Phone (317) 796-1797

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
I20240807003187 IN Practitioner - Clinical Social Worker 8527505544 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34007543AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Jul 11, 2024 Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince May 1, 2025 Accepting new patients

Locations

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

333 N Alabama St
Indianapolis, IN 46204
Phone (317) 395-3391

333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002

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

Organizations & group practices 3

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": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1811747058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3054 RUCKLE ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053968",
            "telephone_number": "317-796-1797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3054 RUCKLE ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053968",
            "telephone_number": "317-796-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "DANELLE",
        "middle_name": "JEAN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IN",
            "license": "34007543A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34007543A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IN",
            "license": "34007543A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "34007543A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007543A",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "34007543A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.