Individual provider Active NPI

Erica Camarena

  • Clinical Social Worker
  • Kankakee, IL
National Provider Identifier
1205524469
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149027658 Issued in IL
Practice address
70 Meadowview Ctr Ste 100
Kankakee, IL 60901-2047
Phone
(815) 432-5241
NPI assigned
Apr 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150105584 IL
Clinical Social Worker 1041C0700X 149027658 IL Primary

Addresses

Primary practice location

70 Meadowview Ctr Ste 100
Kankakee, IL 60901-2047

Mailing address

PO Box 322
Watseka, IL 60970-0322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149027658ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Iroquois Mental Health Center CurrentSince Sep 21, 2024 Accepting new patients

Locations

323 W Mulberry St
Watseka, IL 60970
Phone 8152694769555

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1205524469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 322",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609700322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEADOWVIEW CTR STE 100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012047",
            "telephone_number": "815-432-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMARENA",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150105584",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.