Individual provider Active NPI

Geneva Osawe, LCSW, LMFT

  • Clinical Social Worker
  • Merrillville, IN
National Provider Identifier
1861686701
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34000001 Issued in IN
Practice address
5825 Broadway
Suite D
Merrillville, IN 46410-2687
Phone
(219) 980-4330
Fax
(219) 980-9119
NPI assigned
Sep 4, 2007
Last updated
Sep 4, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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 34000001 IN Primary

Addresses

Primary practice location

5825 Broadway
Suite D
Merrillville, IN 46410-2687

Mailing address

5825 Broadway
Suite D
Merrillville, IN 46410-2687
Phone (219) 980-4330

Other identifiers 2

IdentifierTypeStateIssuer
9001137OtherILBLUE CROSS & SHIELD IL
202580OtherINMEDICARE-TYPE UNSPECIFIED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210506002191 IN Practitioner - Clinical Social Worker 1557770310 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34000001INMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Matters Institute, Inc. Clinical CurrentSince Apr 1, 2021 Accepting new patients

Locations

475 Broadway
Ste 209
Gary, IN 46402
Phone (219) 881-1444

490 W 23rd Ave
Gary, IN 46407
Phone (219) 333-7619

5825 Broadway
Ste D
Merrillville, IN 46410
Phone (219) 980-4330

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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1861686701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 BROADWAY",
            "address_2": "SUITE D",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464102687",
            "telephone_number": "219-980-4330",
            "fax_number": "219-980-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 BROADWAY",
            "address_2": "SUITE D",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464102687",
            "telephone_number": "219-980-4330",
            "fax_number": "219-980-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSAWE",
        "first_name": "GENEVA",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & SHIELD IL",
            "identifier": "9001137",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-TYPE UNSPECIFIED",
            "identifier": "202580",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.