JERRY HAVENS LCSW
NPI 1073566998
Counselor - Mental Health in Marion, IN
About Jerry Havens Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JERRY HAVENS LCSW (NPI 1073566998) is an individual mental health provider in Marion, Indiana, licensed in Indiana (34001583A) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jerry Havens Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jerry Havens reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Marion, IN 46952
- Reassigned Medicare billing, Indiana enrollment
- 40 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jerry Havens's NPI number?
The NPI number for Jerry Havens is 1073566998. It was assigned to this individual provider in the NPPES registry on May 19, 2006.
Where is Jerry Havens located?
Jerry Havens practices at 505 N Wabash Ave, Marion, IN 46952. The listed phone number is (765) 662-3971.
What is Jerry Havens's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Jerry Havens enrolled in Medicare?
Yes. Jerry Havens is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jerry Havens's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jerry Havens reassigns Medicare benefits to Grant-Blackford Mental Health, Inc. (Marion, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jerry Havens's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jerry Havens was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jerry Havens, LCSW · NPI 1073566998
Mental Health provider in Marion, Indiana. Individual provider, active in the CMS NPPES registry since May 19, 2006.
## Identity
- **NPI:** 1073566998 (Entity type: Individual)
- **Enumerated:** May 19, 2006
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 34001583A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 505 N WABASH AVE, Marion, IN 46952-2608
- **Phone:** (765) 662-3971
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grant-Blackford Mental Health, Inc. (NPI 1437983103, Marion, IN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 13, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1073566998) · Data from the CMS NPPES public registry.