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

Justine Wise, LCSW

Individual provider Clinical Social Worker · NPI 1164935078

Justine Wise, LCSW is a Clinical Social Worker in South Bend, Indiana. Qualified in 2017, 9 years ago. Practices with Beacon Medical Group Inc, a 574-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
9
Licensed in
IN
In the registry since
2017
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

2235 Cleveland Rd
South Bend, IN 46628-3529
Phone: (574) 647-4530
Fax: (574) 647-2285
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3301 County Road 6 E, Elkhart, IN 46514-7673 — (574) 264-9635

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 34009127A (IN)

Record details

NPI number1164935078
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 14, 2017
Last updated in NPPESJanuary 4, 2026
Certification dateJanuary 4, 2026
Mailing address3245 Health Dr Ste 100, Granger, IN 46530-1380

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Beacon Medical Group Inc — 574 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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