Individual provider Active NPI

William B McCracken, LCSW,ICADC

  • Clinical Social Worker
  • Wilmington, DE
National Provider Identifier
1003586710
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0000564 Issued in DE
Practice address
2607 N Harrison St
Wilmington, DE 19802-2922
Phone
(302) 307-1779
NPI assigned
Sep 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12735 MD
Clinical Social Worker 1041C0700X Q1-0000564 DE Primary

Addresses

Primary practice location

2607 N Harrison St
Wilmington, DE 19802-2922

Mailing address

425 Fingerboard Schoolhous Rd
Earleville, MD 21919-1420
Phone (443) 347-4485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220208002020 DE Practitioner - Clinical Social Worker 5092108423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

251 Little Falls Dr
Wilmington, DE 19808-1674
Phone (443) 347-4485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0000564DEMDClinical Social Worker
12735MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Present Center for Mindfulness CurrentSince Sep 23, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1003586710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 FINGERBOARD SCHOOLHOUS RD",
            "city": "EARLEVILLE",
            "state": "MD",
            "postal_code": "219191420",
            "telephone_number": "443-347-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 N HARRISON ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198022922",
            "telephone_number": "302-307-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKEN",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "credential": "LCSW,ICADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-14",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12735",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.