Individual provider Active NPI

Celeste Robinson, LCSW

  • Clinical Social Worker
  • Mount Vernon, IL
National Provider Identifier
1043752280
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018803 Issued in IL
Practice address
107 Shiloh Dr
Mount Vernon, IL 62864-7301
Phone
(618) 242-6944
NPI assigned
Nov 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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 149.018803 IL Primary

Addresses

Primary practice location

107 Shiloh Dr
Mount Vernon, IL 62864-7301

Mailing address

107 Shiloh Dr
Mount Vernon, IL 62864-7301
Phone (618) 242-6944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20181001002893 IL Practitioner - Clinical Social Worker 3779834718 Practice locations: Mount Vernon, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Southern Illinois University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3600 S Water Tower PL
Mount Vernon, IL 62864-6589
Phone (618) 244-0212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.018803ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Spero Family Services 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1043752280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SHILOH DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628647301",
            "telephone_number": "618-242-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SHILOH DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628647301",
            "telephone_number": "618-242-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "CELESTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.