Active NPI
Nicole Hiatt, MSW, LCSW
- Clinical Social Worker
- Logansport, IN
National Provider Identifier
1962797910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34007391A
- Practice address
- 1015 Michigan Ave
Logansport, IN 46947-1526 - Phone
- (574) 722-5151
- Fax
- (574) 739-1414
- NPI assigned
- Jun 17, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 34007391A | IN | Primary |
Addresses
Primary practice location
1015 Michigan Ave
Logansport, IN 46947-1526
Mailing address
800 Fulton St
Attn: Anne Lawson - Credentialing
Logansport, IN 46947-1577
Phone (574) 205-2600
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Indiana Medical College, School of Medicine of Purdue University, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
401 E 8TH St
Suite a
Rochester, IN 46975-1444
Phone (574) 223-8565
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Peru, IN
- NPI 1972545945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453766400000",
"number": "1962797910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 FULTON ST",
"address_2": "ATTN: ANNE LAWSON - CREDENTIALING",
"city": "LOGANSPORT",
"state": "IN",
"postal_code": "469471577",
"telephone_number": "574-205-2600",
"fax_number": "574-739-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 MICHIGAN AVE",
"city": "LOGANSPORT",
"state": "IN",
"postal_code": "469471526",
"telephone_number": "574-722-5151",
"fax_number": "574-739-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIATT",
"first_name": "NICOLE",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-17",
"last_updated": "2016-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34007391A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logansport, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.