Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jay Alan Bastian, LCSW

Individual provider Social Worker · NPI 1912363375

Jay Alan Bastian, LCSW is a Clinical Social Worker in Fort Wayne, Indiana. Qualified in 2014, 12 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
12
Licensed in
IN
In the registry since
2016
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

9329 Illinois Rd
Fort Wayne, IN 46804-5796
Phone: (260) 418-9653
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 33007337A (IN)

Record details

NPI number1912363375
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJanuary 14, 2016
Last updated in NPPESOctober 15, 2024
Certification dateOctober 15, 2024
Mailing address9329 Illinois Rd, Fort Wayne, IN 46804-5796

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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