C.R. Booker Mediation & Counseling Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017310 Issued in IL

Legal business name

C.R. BOOKER MEDIATION & COUNSELING INC.

Practice address

701 Devonshire Dr
C-35
Champaign, IL 61820-7337

Phone

(217) 552-4040

Fax

(217) 398-0413

NPI assigned

Oct 7, 2017

Last updated

Oct 9, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Candyce Booker

Title

Owner/Therapist

Phone

(217) 552-4040

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shevon Brown Walker

  • Mental Health Counselor
  • Champaign, IL
  • NPI 1457123606
  NPD (past)

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

{
    "created_epoch": "1507334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507507200000",
    "number": "1073023776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 KREBS DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221105",
            "telephone_number": "217-552-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR",
            "address_2": "C-35",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207337",
            "telephone_number": "217-552-4040",
            "fax_number": "217-398-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C.R. BOOKER MEDIATION & COUNSELING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-07",
        "last_updated": "2017-10-09",
        "status": "A",
        "authorized_official_last_name": "BOOKER",
        "authorized_official_first_name": "CANDYCE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "217-552-4040"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1295107787",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Champaign, IL
• Providers in Champaign, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.