Active NPI
Cynthia Annette Erdeljac, LCSW
- Clinical Social Worker
- Clinton, MO
National Provider Identifier
1154412971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2005015006
- Practice address
- 702 E Ohio St
Suite 13
Clinton, MO 64735-2371 - Phone
- (660) 885-9100
- Fax
- (660) 885-9116
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2005015006 | MO | Primary |
Addresses
Primary practice location
702 E Ohio St
Suite 13
Clinton, MO 64735-2371
Mailing address
PO Box 746
Clinton, MO 64735-0746
Phone (660) 885-9100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015006 | MO | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BPH LLC | Past | Accepting new patients | |
| Twin Lakes Counseling Center | Clinical | Past | Accepting new patients |
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.
-
- Professional Counselor
- Kansas City, MO
- NPI 1770989303
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1154412971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746",
"city": "CLINTON",
"state": "MO",
"postal_code": "647350746",
"telephone_number": "660-885-9100",
"fax_number": "660-885-9116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 E OHIO ST",
"address_2": "SUITE 13",
"city": "CLINTON",
"state": "MO",
"postal_code": "647352371",
"telephone_number": "660-885-9100",
"fax_number": "660-885-9116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERDELJAC",
"first_name": "CYNTHIA",
"middle_name": "ANNETTE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2005015006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.