Organization Active NPI

Dawn M Neely MSW Licsw PLLC

  • Social Worker
  • Morgantown, WV
National Provider Identifier
1912354523
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
DP00941909 Issued in WV
Legal business name
DAWN M NEELY MSW LICSW PLLC
Practice address
874 Fairmont Rd
Suite C
Morgantown, WV 26501
Phone
(304) 290-8138
Fax
(304) 598-0473
NPI assigned
May 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Authorized official

Name
Dawn Neely, LICSWNPI 1053571893
Title
Owner / Sole Member
Phone
(304) 290-8138

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X DP00941909 WV Primary

Addresses

Primary practice location

874 Fairmont Rd
Suite C
Morgantown, WV 26501

Mailing address

874 Fairmont Rd Ste C
Morgantown, WV 26501-3893
Phone (304) 290-8138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181218001121 WV Part B Supplier - Clinic/Group Practice 8628313707 Receives reassigned benefits from 1 practitioner
Practice locations: Morgantown, WV

National Provider Directory

National Provider Directory

Locations

874 Fairmont Rd
Ste C
Morgantown, WV 26501
Phone (304) 290-7210

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533859200000",
    "number": "1912354523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 FAIRMONT RD STE C",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265013893",
            "telephone_number": "304-290-8138",
            "fax_number": "304-598-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 FAIRMONT RD",
            "address_2": "SUITE C",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26501",
            "telephone_number": "304-290-8138",
            "fax_number": "304-598-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWN M NEELY MSW LICSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2018-08-10",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER / SOLE MEMBER",
        "authorized_official_telephone_number": "304-290-8138",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "WV",
            "license": "DP00941909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.