Individual provider Active NPI

Matthew C. Clayton, MSW, LSW

  • Social Worker
  • Rockford, IL
National Provider Identifier
1184400145
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.111249 Issued in IL
Practice address
8038 Macintosh LN
Rockford, IL 61107-5336
Phone
(815) 997-6836
Fax
(779) 552-8443
NPI assigned
Sep 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 150.111249 IL Primary

Addresses

Primary practice location

8038 Macintosh LN
Rockford, IL 61107-5336

Mailing address

9853 N Alpine Rd # 202
Machesney Park, IL 61115-1681
Phone (815) 997-6836

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
I20240314003035 IL Practitioner - Clinical Social Worker 5496191231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clayton and Clayton Counseling, PLLCGroup PAC ID 0749626588, 2 clinicians

Practice addresses (Care Compare)

8038 Macintosh LN
Rockford, IL 61107-5336
Phone (815) 708-7411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.111249ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clayton & Clayton Counseling, PLLC Single Specialty CurrentSince Jan 24, 2024 Accepting new patients

Locations

8038 Macintosh Ln
Rockford, IL 61107
Phone (815) 332-6800

5062 Rockrose Ct
Roscoe, IL 61073
Phone (815) 708-7411

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1184400145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9853 N ALPINE RD # 202",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611151681",
            "telephone_number": "815-997-6836",
            "fax_number": "779-552-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8038 MACINTOSH LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075336",
            "telephone_number": "815-997-6836",
            "fax_number": "779-552-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "MATTHEW",
        "middle_name": "C.",
        "credential": "MSW, LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.111249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.