Wayne C Funk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW016288 Issued in PA

Practice address

545 Kiefer Ave
Hazleton, PA 18201-7701

Phone

(570) 459-5615

NPI assigned

Mar 6, 2011

Last updated

Feb 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1299369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1821396433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 KIEFER AVE",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182017701",
            "telephone_number": "570-579-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 KIEFER AVE",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182017701",
            "telephone_number": "570-459-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "WAYNE",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-06",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dora Hannah Foderaro, MS, CCC-SLP
• Theresa M Fonash, M.D.
• Sharon Susan Forlenza-Stevens, RN,CRNP
• Frank M. Scatton
• Kimberly Franks, LPC
• Harsh Gandhi, MD
• Raveena Gandhi, DO
• Susan Joann Garrett, RN, BSN
• Daniel Gavio, DC
• Ronald John Gavlick, MA

• Clinical Social Worker in Hazleton, PA
• Providers in Hazleton, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.