Jay Alan Bastian, LCSW
NPI 1912363375ActiveIndividual· Social Worker· Fort Wayne, IN
Social Worker (LCSW) in Fort Wayne, Indiana, licensed in IN, with an NPI issued in January 2016. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1912363375 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | Yes |
| NPI issued | Jan 14, 2016 |
| Last updated in NPPES | Oct 15, 2024 |
| Certified by provider | Oct 15, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | 33007337A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (IN) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
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