Individual provider Active NPI

Jonathan Thomas Laucella, MSW, LCSW

  • Clinical Social Worker
  • Bloomington, IN
National Provider Identifier
1821646076
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009643A Issued in IN
Practice address
1332 W Arch Haven Ave Ste a
Bloomington, IN 47403-2078
Phone
(317) 656-9613
Fax
(317) 988-5525
NPI assigned
Aug 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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 34009643A IN Primary

Addresses

Primary practice location

1332 W Arch Haven Ave Ste a
Bloomington, IN 47403-2078

Mailing address

1332 W Arch Haven Ave Ste a
Bloomington, IN 47403-2078
Phone (317) 656-9613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Onhealthcare LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1821646076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 W ARCH HAVEN AVE STE A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032078",
            "telephone_number": "317-656-9613",
            "fax_number": "317-988-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 W ARCH HAVEN AVE STE A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032078",
            "telephone_number": "317-656-9613",
            "fax_number": "317-988-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUCELLA",
        "first_name": "JONATHAN",
        "middle_name": "THOMAS",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-30",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009643A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.