Jill Erickson

Individual provider Active NPI Clinical Social Worker · Watseka, IL

NPI 1346867660 · NPPES record last updated Apr 18, 2022

Key facts

NPI
1346867660
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149024452 (IL)
Practice address
323 W Mulberry St
Watseka, IL 60970-1568
Phone
(815) 432-5241
NPI assigned
Jul 2, 2020
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iroquois Mental Health Center (5 clinicians)

Practice addresses (Care Compare)

323 W Mulberry St
Watseka, IL 60970-1568
Phone 8154325241201

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230503003056 IL Practitioner - Clinical Social Worker 4082079645 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Iroquois Mental Health Center Current
since Feb 19, 2023
Accepting new patients

Locations

323 W Mulberry St
Watseka, IL 60970
Phone 8152694769201

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 149024452 IL Yes

Addresses

Primary practice location

323 W Mulberry St
Watseka, IL 60970-1568

Mailing address

PO Box 322
Watseka, IL 60970-0322

Other providers in Watseka, IL

All providers in Watseka, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.