Individual provider Active NPI

Max Allen Schut, MSW, LCSW

  • Clinical Social Worker
  • South Bend, IN
National Provider Identifier
1932768777
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007679A Issued in IN
Practice address
220 W Colfax Ave Ste 400
South Bend, IN 46601-1635
Phone
(574) 546-1900
Fax
(574) 546-1999
NPI assigned
Jun 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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 34007679A IN Primary

Addresses

Primary practice location

220 W Colfax Ave Ste 400
South Bend, IN 46601-1635

Mailing address

220 W Colfax Ave Ste 400
South Bend, IN 46601-1635
Phone (574) 546-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • 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
I20190619002453 IN Practitioner - Clinical Social Worker 0749514123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Indiana University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oaklawn Psychiatric Center IncGroup PAC ID 6002801065, 66 clinicians

Practice addresses (Care Compare)

2600 Oakland Ave
Elkhart, IN 46517-1533
Phone (574) 533-1234

330 Lakeview Dr
Goshen, IN 46528-9365
Phone (574) 533-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34007679AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oaklawn Psychiatric Center, Inc. CurrentSince Apr 8, 2021 Accepting new patients
Oaklawn Psychiatric Center, Inc. CurrentSince Apr 8, 2021 Accepting new patients

Locations

330 Lakeview Dr
Goshen, IN 46528
Phone (219) 533-1234

Organizations & group practices 2

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": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1932768777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W COLFAX AVE STE 400",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011635",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W COLFAX AVE STE 400",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011635",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUT",
        "first_name": "MAX",
        "middle_name": "ALLEN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007679A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.