Individual provider Active NPI

Mary Suzanne Janke, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1952737314
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004322A Issued in IN
Practice address
921 E 86TH St Ste 206
Indianapolis, IN 46240-1841
Phone
(812) 805-0082
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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 34004322A IN Primary

Addresses

Primary practice location

921 E 86TH St Ste 206
Indianapolis, IN 46240-1841

Mailing address

12932 Desplaines Dr
Fishers, IN 46037-7827
Phone (317) 407-8198

Other practice location 1

6950 Hillsdale Ct
Indianapolis, IN 46250-2040
Phone (317) 621-7740

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
I20150507001740 IN Practitioner - Clinical Social Worker 2567781818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Health Network IncGroup PAC ID 1850203977, 95 clinicians

Practice addresses (Care Compare)

1525 N Ritter Ave
Gallahue Mental Health Services
Indianapolis, IN 46219-3026
Phone (317) 359-5467

Merit-based Incentive Payment System (MIPS)

Final score
99.82 of 100Reported as group
Quality
96.14
Promoting interoperability
100
Improvement activities
40
Cost
82.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Viaquest Community Solutions, LLC CurrentSince Aug 14, 2022 Accepting new patients
Community Health Network, Inc Current Accepting new patients

Locations

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

7830 Johnson Rd
Indianapolis, IN 46250
Phone (317) 396-0683

1525 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 322-4087

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": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1952737314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12932 DESPLAINES DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377827",
            "telephone_number": "317-407-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 E 86TH ST STE 206",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401841",
            "telephone_number": "812-805-0082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6950 Hillsdale Ct",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462502040",
            "country_code": "US",
            "telephone_number": "317-621-7740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANKE",
        "first_name": "MARY",
        "middle_name": "SUZANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004322A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.