Organization Active NPI

Candy Crawford LCSW Inc

  • Clinical Social Worker
  • Wheaton, IL
National Provider Identifier
1356613038
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013389 Issued in IL
Legal business name
CANDY CRAWFORD LCSW INC
Practice address
2100 Manchester Rd BLDG B
Wheaton, IL 60187-4579
Phone
(630) 991-6200
NPI assigned
Jan 27, 2012
Last updated
Jan 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Authorized official

Name
Mrs. Candy L Crawford, LCSW
Title
President
Phone
(630) 991-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.013389 IL Primary

Addresses

Primary practice location

2100 Manchester Rd BLDG B
Wheaton, IL 60187-4579

Mailing address

2100 Manchester Rd BLDG B
Ste 900
Wheaton, IL 60187-4579
Phone (630) 991-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251125001063 IL Part B Supplier - Clinic/Group Practice 2264924422 Receives reassigned benefits from 1 practitioner
Practice locations: Batavia, IL

National Provider Directory

National Provider Directory

Locations

2100 Manchester Rd
Ste 900
Wheaton, IL 60187
Phone (630) 665-1255

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1356613038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD BLDG B",
            "address_2": "STE 900",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874579",
            "telephone_number": "630-991-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD BLDG B",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874579",
            "telephone_number": "630-991-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDY CRAWFORD LCSW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "CANDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-991-6200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.