Individual provider Active NPI

Erin Dover, LICSW

  • Clinical Social Worker
  • Cullman, AL
National Provider Identifier
1013426295
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4508C Issued in AL
Practice address
1909 Commerce Ave
Cullman, AL 35055-6151
Phone
(256) 734-4688
NPI assigned
Sep 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 4508C AL
Clinical Social Worker 1041C0700X 4508C AL Primary

Addresses

Primary practice location

1909 Commerce Ave
Cullman, AL 35055-6151

Mailing address

1909 Commerce Ave
Cullman, AL 35055-6151

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
I20211019001180 AL Practitioner - Clinical Social Worker 2961890272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstone, Inc.Group PAC ID 9739070046, 18 clinicians

Practice addresses (Care Compare)

1909 Commerce Ave
Cullman, AL 35055-6151
Phone (256) 734-4688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4508CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstone, Inc. Mental Health CurrentSince Jul 15, 2021 Accepting new patients

Locations

1909 Commerce Ave
Cullman, AL 35055
Phone (256) 734-4688

4040 Memorial Pkwy SW
Huntsville, AL 35802
Phone (256) 533-1970

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": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1013426295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 COMMERCE AVE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350556151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 COMMERCE AVE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350556151",
            "telephone_number": "256-734-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVER",
        "first_name": "ERIN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "4508C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4508C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.