Individual provider Active NPI

Brandi E Watson, MSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1255858452
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33008330A Issued in IN
Practice address
25 W Division St
Evansville, IN 47710-1374
Phone
(812) 436-0205
Fax
(813) 436-0207
NPI assigned
Aug 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 33008330A IN Primary

Addresses

Primary practice location

25 W Division St
Evansville, IN 47710-1374

Mailing address

315 Mulberry St
Evansville, IN 47713-1252
Phone (812) 421-7489

Other practice location 1

315 Mulberry St
Evansville, IN 47713-1252
Phone (812) 421-7489

Other identifiers 1

IdentifierTypeStateIssuer
33008330AOtherININ MSW LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20200210002104 IN Practitioner - Clinical Social Worker 3577999697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

309 N Sawmill St
Mount Vernon, IN 47620-2006
Phone (812) 838-6558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33008330AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Behavioral Healthcare, Inc. CurrentSince Jan 4, 2021 Accepting new patients
Southwestern Behavioral Healthcare, Inc. CurrentSince Jan 4, 2021 Accepting new patients

Locations

415 Mulberry St
Evansville, IN 47713
Phone (812) 436-4232

309 N Sawmill St
Mount Vernon, IN 47620
Phone (812) 383-6558

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.

NPI Registry JSON

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255858452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131252",
            "telephone_number": "812-421-7489",
            "fax_number": "812-436-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W DIVISION ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101374",
            "telephone_number": "812-436-0205",
            "fax_number": "813-436-0207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Mulberry St",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477131252",
            "country_code": "US",
            "telephone_number": "812-421-7489",
            "fax_number": "812-421-7497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "BRANDI",
        "middle_name": "E",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "33008330A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN MSW LICENSE",
            "identifier": "33008330A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.