Individual provider Active NPI

Susan Rebecca Williamson, LSCW

  • Clinical Social Worker
  • Muncie, IN
National Provider Identifier
1184677460
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004763A Issued in IN
Practice address
240 N Tillotson Ave
Muncie, IN 47304-3988
Phone
(765) 288-1928
Fax
(765) 741-0306
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 34004763A IN Primary

Addresses

Primary practice location

240 N Tillotson Ave
Muncie, IN 47304-3988

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Other names 1

  • Susan Rebecca Reid Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OR, AK3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040911000157 IN Practitioner - Clinical Social Worker 1052388923 Reassigns benefits to 2 organizations
I20240918003137 OR Practitioner - Clinical Social Worker 1052388923 Reassigns benefits to 1 organization
I20241206003073 AK Practitioner - Clinical Social Worker 1052388923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Four County Comprehensive Mental Health Center IncGroup PAC ID 2163334277, 42 clinicians
Midwest Behavioral Health LLCGroup PAC ID 4587834874, 132 clinicians
Ah Addiction Care PCGroup PAC ID 2668916214, 3 clinicians

Practice addresses (Care Compare)

1060 S Main St
Tipton, IN 46072-8327
Phone (574) 722-5151

10967 Allisonville Rd
Suite 240
Fishers, IN 46038-2634
Phone (812) 401-8008

1390 Umpqua Ave
Apt 201
Eugene, OR 97408-6075
Phone (844) 542-5481

4367 Taku Blvd
Juneau, AK 99801-9289
Phone (844) 542-5481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ah Addiction Care PC CurrentSince Sep 7, 2024 Accepting new patients
Four County Comprehensive Mental Health Center, Inc CurrentSince Sep 22, 2025 Accepting new patients
Four County Comprehensive Mental Health Center Inc CurrentSince Sep 22, 2025 Accepting new patients
Ah Addiction Care of California PC PastSince Sep 8, 2024 Accepting new patients

Locations

721 Depot Dr
Anchorage, AK 99501
Phone (201) 293-7689

303 Twin Dolphin Dr
Ste 6006002
Redwood City, CA 94065

1015 Michigan Ave
Logansport, IN 46947

2355 S Business 31
Peru, IN 46970

1060 S Main St
Tipton, IN 46072
Phone (765) 675-1111

2900 NW Clearwater Dr
Ste 200109
Bend, OR 97703
Phone (740) 350-3565

520 SW 6th Ave
Ste 1250
Portland, OR 97204

Organizations & group practices 5

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184677460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "SUSAN",
        "middle_name": "REBECCA",
        "credential": "LSCW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004763A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "REID",
            "middle_name": "REBECCA",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.