Bloomington Center for Connection Benefit Corporation

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLOOMINGTON CENTER FOR CONNECTION BENEFIT CORPORATION

Practice address

315 W Dodds St
Bloomington, IN 47403-2510

Phone

(812) 669-2227

NPI assigned

Aug 9, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Amy C Makice, LCSWNPI 1093220139

Title

Director

Phone

(812) 669-2227

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy C Makice, MSW, LCSW

  • Clinical Social Worker
  • Bloomington, IN
  • NPI 1093220139
  Medicare reassignment NPD Authorized official
• Jessica Troxel, LCSW

  • Clinical Social Worker
  • Bloomington, IN
  • NPI 1558959874
  NPD

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1316612765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W DODDS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032510",
            "telephone_number": "812-669-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W DODDS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032510",
            "telephone_number": "812-669-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMINGTON CENTER FOR CONNECTION BENEFIT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "MAKICE",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "812-669-2227",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.simplepractice.com/",
            "affiliation": "N",
            "endpointDescription": "telehealth platform",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Simple Practice Telehealth platform",
            "address_1": "315 W Dodds St",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474032510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.