Meredith McCook Prosak, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7798 Issued in TN

Practice address

202 W Fairview Ave
Johnson City, TN 37604-5611

Phone

(423) 439-7371

Fax

(423) 232-0420

NPI assigned

Oct 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Tennessee State UniversityGroup PAC ID 2769394774, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• East Tennessee State University

  • Federally Qualified Health Center (FQHC)
  • Johnson City, TN
  • NPI 1093990608
  Medicare reassignment Care Compare group NPD
• East Tennessee State University

  • Federally Qualified Health Center (FQHC)
  • Johnson City, TN
  • NPI 1477660199
  NPD (past)
• East Tennessee State University

  • Multi-Specialty Clinic/Center
  • Johnson City, TN
  • NPI 1568570273
  NPD (past)

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1932861671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045611",
            "telephone_number": "423-439-7371",
            "fax_number": "423-232-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045611",
            "telephone_number": "423-439-7371",
            "fax_number": "423-232-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSAK",
        "first_name": "MEREDITH",
        "middle_name": "MCCOOK",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Procompounding
• Kerry Ellen Proctor-Williams, PH.D., CCC-SLP
• Professional Respiratory Services, LLC
• Amy L Proffitt, MD
• Lenzie Faith Proffitt
• Providence Companion Care of TN 1, LLC
• Bryan J Prudhomme, MD
• Psychological Consulting Services
• PT Solutions LLC
• Publix Tennessee, LLC

• Clinical Social Worker in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.