Individual provider Active NPI

Bernadette A. Makosky, L.I.S.W.

  • Clinical Social Worker
  • Lancaster, OH
National Provider Identifier
1962497008
Registry record updated Nov 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.100840 Issued in OH
Practice address
337 E Main St
Lancaster, OH 43130-3845
Phone
(740) 407-3213
Fax
(740) 785-5189
NPI assigned
Sep 14, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X I.100840 OH Primary

Addresses

Primary practice location

337 E Main St
Lancaster, OH 43130-3845

Mailing address

2020 N Glenn Dr NE
Lancaster, OH 43130-9759
Phone (740) 407-3213

Other identifiers 3

IdentifierTypeStateIssuer
272168000OtherIAAETNA
272168000OtherIAMAGELLAN
36075OtherIABLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20181128002816 OH Practitioner - Clinical Social Worker 5395780654 Practice locations: Lancaster, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.100840OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541203200000",
    "number": "1962497008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 N GLENN DR NE",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431309759",
            "telephone_number": "740-407-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303845",
            "telephone_number": "740-407-3213",
            "fax_number": "740-785-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKOSKY",
        "first_name": "BERNADETTE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "L.I.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2018-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.100840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "272168000",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "272168000",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "36075",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.