Individual provider Active NPI

Allison Brockway, MSW, LCSW

  • Clinical Social Worker
  • Waynesville, MO
National Provider Identifier
1124898705
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.025803 Issued in IL
Practice address
203 Frances St
Waynesville, MO 65583-2305
Phone
(309) 369-3351
NPI assigned
Jan 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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 149.025803 IL Primary

Addresses

Primary practice location

203 Frances St
Waynesville, MO 65583-2305

Mailing address

203 Frances St
Waynesville, MO 65583-2305
Phone (309) 369-3351

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
I20250409002298 IL Practitioner - Clinical Social Worker 3274057476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

332 S Michigan Ave
Chicago, IL 60604-4301
Phone (323) 205-7088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince Apr 7, 2025 Accepting new patients

Locations

332 S Michigan Ave
Chicago, IL 60604
Phone (773) 633-7479

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": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1124898705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 FRANCES ST",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832305",
            "telephone_number": "309-369-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 FRANCES ST",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832305",
            "telephone_number": "309-369-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKWAY",
        "first_name": "ALLISON",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.025803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, MO

Sources for this page

Verify at the official NPI Registry.