Individual provider Active NPI

Christina M Plenge, MSW, LCSW

  • Clinical Social Worker
  • Hannibal, MO
National Provider Identifier
1285812941
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2007038383 Issued in MO
Practice address
154 Forrest Dr
Hannibal, MO 63401-5511
Phone
(573) 221-2120
NPI assigned
Feb 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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 2007038383 MO Primary

Addresses

Primary practice location

154 Forrest Dr
Hannibal, MO 63401-5511

Mailing address

154 Forrest Dr
Hannibal, MO 63401-5511
Phone (573) 221-2120

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200401002312 MO Practitioner - Clinical Social Worker 2264861905 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Twain Association for Mental Health, Inc. CurrentSince Mar 16, 2020 Accepting new patients
Mark Twain Association for Mental Health, Inc CurrentSince Mar 16, 2020 Accepting new patients

Locations

154 Forrest Dr
Hannibal, MO 63401
Phone (573) 221-2120

917 Broadway
Hannibal, MO 63401
Phone (573) 221-2120

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1285812941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 FORREST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634015511",
            "telephone_number": "573-221-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 FORREST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634015511",
            "telephone_number": "573-221-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLENGE",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2007038383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.