JUSTINE WISE LCSW
NPI 1164935078
Social Worker - Clinical in South Bend, IN
About Justine Wise Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JUSTINE WISE LCSW (NPI 1164935078) is an individual clinical provider in South Bend, Indiana, licensed in Indiana (34009127A) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Justine Wise Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46628 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SOUTH BEND, IN 46628
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 Justine Wise's NPI number?
The NPI number for Justine Wise is 1164935078. It was assigned to this individual provider in the NPPES registry on November 14, 2017.
Where is Justine Wise located?
Justine Wise practices at 2235 Cleveland Rd, South Bend, IN 46628. The listed phone number is (574) 647-4530.
What is Justine Wise's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Justine Wise enrolled in Medicare?
Yes. Justine Wise is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Justine Wise was last updated on January 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Justine Wise, LCSW · NPI 1164935078
Clinical provider in South Bend, Indiana. Individual provider, active in the CMS NPPES registry since November 14, 2017.
## Identity
- **NPI:** 1164935078 (Entity type: Individual)
- **Enumerated:** November 14, 2017
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 34009127A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 2235 CLEVELAND RD, South Bend, IN 46628-3529
- **Phone:** (574) 647-4530 · **Fax:** (574) 647-2285
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** January 4, 2026
- **Other identifiers:** Medicaid 300121318 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1164935078) · Data from the CMS NPPES public registry.