Individual provider Active NPI

Erin Joan Cluts, MSW, LCSW

  • Clinical Social Worker
  • St Charles, IL
National Provider Identifier
1104077189
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149008685 Issued in IL
Practice address
103 N 11TH Ave
Suite 109
St Charles, IL 60174-2289
Phone
(630) 799-0100
Fax
(630) 799-0180
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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 149008685 IL Primary

Addresses

Primary practice location

103 N 11TH Ave
Suite 109
St Charles, IL 60174-2289

Mailing address

616 W 5TH Ave
Suite B
Naperville, IL 60563-2914
Phone (630) 799-0100

Other names 1

  • Miss Erin Joan Quillman Former name

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
I20090202000580 IL Practitioner - Clinical Social Worker 4183689318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dunham Counseling Center LTDGroup PAC ID 1456418219, 2 clinicians

Practice addresses (Care Compare)

616 W 5TH Ave
Suite B
Naperville, IL 60563-2929
Phone (630) 799-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dunham Counseling Center, LTD. Clinical CurrentSince Jul 1, 2013 Accepting new patients
Heartland Behavioral Health SC PastSince Feb 27, 2018 Accepting new patients

Locations

616 W 5th Ave
Ste B
Naperville, IL 60563
Phone (630) 717-7771

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1104077189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 W 5TH AVE",
            "address_2": "SUITE B",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632914",
            "telephone_number": "630-799-0100",
            "fax_number": "630-799-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N 11TH AVE",
            "address_2": "SUITE 109",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742289",
            "telephone_number": "630-799-0100",
            "fax_number": "630-799-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUTS",
        "first_name": "ERIN",
        "middle_name": "JOAN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "QUILLMAN",
            "middle_name": "JOAN",
            "prefix": "MISS",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.