Active NPI
Carolyn Cruse
- Mental Health Counselor
- Paxton, IL
National Provider Identifier
1023465952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1510 W Ottawa Rd
Paxton, IL 60957-4090 - Phone
- (217) 379-4302
- Fax
- (217) 379-4304
- NPI assigned
- May 20, 2016
- Last updated
- May 20, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary |
Addresses
Primary practice location
1510 W Ottawa Rd
Paxton, IL 60957-4090
Mailing address
1510 W Ottawa Rd
Paxton, IL 60957-4090
Phone (217) 379-4302
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 20, 2021 through May 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steadfast Center LLC | Mental Health | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Champaign, IL
- NPI 1659855997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463702400000",
"number": "1023465952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1510 W OTTAWA RD",
"city": "PAXTON",
"state": "IL",
"postal_code": "609574090",
"telephone_number": "217-379-4302",
"fax_number": "217-379-4304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 W OTTAWA RD",
"city": "PAXTON",
"state": "IL",
"postal_code": "609574090",
"telephone_number": "217-379-4302",
"fax_number": "217-379-4304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUSE",
"first_name": "CAROLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-20",
"last_updated": "2016-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paxton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.