Individual provider Active NPI

William Robert Enlow, MSW, LCSW

  • Clinical Social Worker
  • Avon, IN
National Provider Identifier
1922190206
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005104A Issued in IN
Practice address
6655 E US 36
Avon, IN 46123-8923
Phone
(317) 272-3421
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 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 34005104A IN Primary

Addresses

Primary practice location

6655 E US 36
Avon, IN 46123-8923

Mailing address

1442 Bank PL
Bridgeport, IN 46231-5227
Phone (317) 246-7460

Other identifiers 1

IdentifierTypeStateIssuer
000000492127OtherINANTHEM BCBS PROVIDER PIN

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

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1922190206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 BANK PL",
            "city": "BRIDGEPORT",
            "state": "IN",
            "postal_code": "462315227",
            "telephone_number": "317-246-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 E US 36",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461238923",
            "telephone_number": "317-272-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENLOW",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005104A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PROVIDER PIN",
            "identifier": "000000492127",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

Verify at the official NPI Registry.