Individual provider Active NPI

Patricia Ann Erwin, LCSW

  • Clinical Social Worker
  • Mexico, MO
National Provider Identifier
1023170966
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
002480 Issued in MO
Practice address
340 Kelley Pkwy
Mexico, MO 65265-3811
Phone
(573) 582-1234
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2022

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 002480 MO Primary

Addresses

Primary practice location

340 Kelley Pkwy
Mexico, MO 65265-3811

Mailing address

340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234

Other identifiers 1

IdentifierTypeStateIssuer
493412928MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20220531000387 MO Practitioner - Clinical Social Worker 1850779026 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002480MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
East Central Missouri Behavioral Health Services, Inc CurrentSince May 23, 2022 Accepting new patients
East Central Missouri Behavioral Health Services, Inc CurrentSince May 23, 2022 Accepting new patients

Locations

340 Kelley Pkwy
Mexico, MO 65265
Phone 5735821234 ext. 3017

Interoperability endpoints

  • Direct secure messaging: patricia.erwin.p1@direct.arthurcenter.nextgenshare.com

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1023170966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERWIN",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "002480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493412928",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mexico, MO

Sources for this page

Verify at the official NPI Registry.