Active NPI
Donna M Skorupski, MSW
- Clinical Social Worker
- Mishawaka, IN
National Provider Identifier
1831187756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34005089A
- Practice address
- 1818 Went Ave Ste a
Mishawaka, IN 46545-6482 - Phone
- (574) 254-0229
- Fax
- (574) 254-0188
- NPI assigned
- Oct 13, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34005089A | IN | Primary |
Addresses
Primary practice location
1818 Went Ave Ste a
Mishawaka, IN 46545-6482
Mailing address
240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000365162 | Other | IN | UNICARE |
| 593552000 | Other | IN | MAGELLAN |
| 000000365162 | Other | IN | ANTHEM |
| 2328863 | Other | IN | CIGNA |
| PVPB106032 | Other | IN | AMERICAN PSYCH SYSTEMS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1831187756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 N TILLOTSON AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043988",
"telephone_number": "765-288-1928",
"fax_number": "765-741-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1818 WENT AVE STE A",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465456482",
"telephone_number": "574-254-0229",
"fax_number": "574-254-0188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKORUPSKI",
"first_name": "DONNA",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-13",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34005089A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNICARE",
"identifier": "000000365162",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "593552000",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000365162",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2328863",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN PSYCH SYSTEMS",
"identifier": "PVPB106032",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.