Individual provider Active NPI

Laurel Custer

  • Clinical Social Worker
  • Madison, AL
National Provider Identifier
1003588179
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1634 Slaughter Rd Ste C
Madison, AL 35758-5914
Phone
(256) 822-2375
Fax
(256) 584-2330
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1634 Slaughter Rd Ste C
Madison, AL 35758-5914

Mailing address

251 Johnston St SE Ste 100
Decatur, AL 35601-2515
Phone (256) 822-2375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20211210000946 AL Practitioner - Clinical Social Worker 5395135107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Counseling and Consulting LLCGroup PAC ID 2769789551, 17 clinicians

Practice addresses (Care Compare)

1634 Slaughter Rd
Suite C
Madison, AL 35758-5914
Phone (256) 822-2375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Counseling & Consulting LLC CurrentSince Sep 15, 2022 Accepting new patients

Locations

14790 Brownsferry Rd
Athens, AL 35611
Phone (256) 822-2375

251 Johnston St SE
Ste 100
Decatur, AL 35601
Phone (256) 822-2375

16 Moulton St E
Decatur, AL 35601
Phone (256) 822-2375

1634 Slaughter Rd
Ste C
Madison, AL 35758
Phone (256) 822-2375

Networks

  • MS PPO D-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • FL PPO
  • TN PPO C-SNP
  • TN PPO
  • FL HMO D-SNP
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • MS PPO C-SNP
  • MS PPO
  • AL HMO D-SNP
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • AL HMO

Organizations & group practices 1

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1003588179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 JOHNSTON ST SE STE 100",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012515",
            "telephone_number": "256-822-2375",
            "fax_number": "256-584-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 SLAUGHTER RD STE C",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585914",
            "telephone_number": "256-822-2375",
            "fax_number": "256-584-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTER",
        "first_name": "LAUREL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.