Corey Craig Crutchfield I, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2014026537 Issued in MO

Practice address

1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318

Phone

(573) 778-4152

Fax

(573) 778-4154

NPI assigned

Jan 15, 2014

Last updated

Dec 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Clinical Social Worker

Education

University of Missouri, Columbia School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Counseling Center IncGroup PAC ID 2163410481, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Kennett, MO
  • NPI 1669477550
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1205258944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 EAGLE RDG",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639019187",
            "telephone_number": "573-712-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013318",
            "telephone_number": "573-778-4152",
            "fax_number": "573-778-4154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Eagle Rdg",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639019187",
            "country_code": "US",
            "telephone_number": "573-712-0701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUTCHFIELD",
        "first_name": "COREY",
        "middle_name": "CRAIG",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-15",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2014026537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Cross, PT
• Richard Scott Crouse, FNP
• Monique Crowley, LCSW
• Crown Hospice of Poplar Bluff, LLC (Crown Hospice)
• Mike Crunk
• Noah J Crutchfield
• Vener Lanting Cuevas
• Christina J Cunningham, MS
• Sandra Gail Cunningham
• Malachi Colm Curnutt

• Clinical Social Worker in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.