MR. PHILLIP A. WILBURN (NPI# 1720005440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720005440 |
| Entity Type | Individual |
| Full Name | MR. PHILLIP A. WILBURN |
| Credential | LCSW |
| Practice Address |
5241 Fountain Dr Suite G Crown Point IN 46307-5323 |
| Mailing Address |
3938 W 78th Ct # 31 Merrillville IN 46410-8705 |
| Practice Telephone | 2193815648 |
| Practice Fax Number | 2197362998 |
| Mailing Telephone | 2193815648 |
| Mailing Fax Number | 2197362998 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-12-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
149-001105 | IL | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34001917A | IN | Behavioral Health & Social Service Providers |
| Street Address |
5241 FOUNTAIN DR SUITE G |
| City | CROWN POINT |
| State | IN |
| Zip Code | 46307-5323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336336551 | Antoinette Weltmeyer | Occupational Therapist | 5241 Fountain Dr, Crown Point, IN 46307-5323 | 2007-10-02 |
| 1578750832 | Mary Anne Levander | Physical Therapist | 5241 Fountain Dr, Suite E, Crown Point, IN 46307-5323 | 2007-10-01 |
| 1245369388 | Theraputx, Inc | Physical Therapist | 5241 Fountain Dr, Suite E, Crown Point, IN 46307-5323 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117935 | Alimat O Biokoro | Home Health Aide | 1446 W 94th Ct., Crown Point, IN 46307 | 2020-09-06 |
| 1508489931 | Gentle Hearts Cardiovascular Institution LLC | Internal Medicine | 5221 W Lincoln Hwy, Suite 1a, Crown Point, IN 46307 | 2020-05-20 |
| 1659933646 | Darshak Joshi | Physical Therapist | 860 Stillwater Parkway, Crown Point, IN 46307 | 2019-07-01 |
| 1215592001 | Jamie Monday | Counselor | 1416 East Joliet St., Crown Point, IN 46307 | 2019-05-07 |
| 1790281152 | Tempus Labs Inc. | Clinical Medical Laboratory | 9800 Connecticut Drive, Suite A2-100, Crown Point, IN 46307 | 2018-04-04 |
| 1669991170 | Katie Lynn Eich | Counselor | 1308 N. Main St, Crown Point, IN 46307 | 2017-09-15 |
| 1053847251 | Nicole Bashan Lewis | Counselor | 1325 W 98th Ave, Crown Point, IN 46307 | 2017-05-08 |
| 1710433008 | Paul Alvin Clavecilla | Physical Therapist | 1099 South Main St., Apt. 314, Crown Point, IN 46307 | 2016-08-28 |
| 1851761365 | Cynthia Catherine Grass Black | Social Worker | 8592 Bell Lane, Crown Point, IN 46307 | 2015-09-28 |
| 1326437799 | Ameya Dorsatwar | Physical Therapist | 1516 North Main St, Crown Point, IN 46307 | 2015-01-22 |
| Find all providers in zip 46307 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871123307 | Tracey Papas | Social Worker | 927 Schilling Dr, Crown Point, IN 46307-0104 | 2020-01-23 |
| 1225549785 | Margaret Patricia Heider | Social Worker | 5521 W Lincoln Hwy Ste 301, Crown Point, IN 46307-1117 | 2017-10-23 |
| 1255782017 | E Mai Pittman | Social Worker | 9370 Tyler St, Crown Point, IN 46307-2275 | 2016-06-23 |
| 1376914499 | Mary Ann Wolfe | Social Worker | 2050 N Main St Ste C, Crown Point, IN 46307-2048 | 2015-10-15 |
| 1851761365 | Cynthia Catherine Grass Black | Social Worker | 8592 Bell Lane, Crown Point, IN 46307 | 2015-09-28 |
| 1043584568 | Susan Marcus | Social Worker | 9150 East 109th Street, Crown Point, IN 46307 | 2012-03-01 |
| 1811023005 | Jennifer Rae Strayer | Social Worker | 1505 S Court St Ste 201, Crown Point, IN 46307-4809 | 2007-02-24 |
| 1861465650 | Robert Krucek II | Social Worker | 9300 Broadway, Crown Point, IN 46307-9830 | 2006-02-10 |
| 1811596596 | Maureen R Reel | Social Worker | 2100 N Main St Ste 304, Crown Point, IN 46307-1877 | 2020-10-22 |
| 1568075836 | Katherine Ann Frazier | Social Worker | 2100 N Main St Ste 304, Crown Point, IN 46307-1877 | 2020-08-26 |
| Find all providers in CROWN POINT | ||||
| City | CROWN POINT |
| Zip Code | 46307 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.