Stephenie Austin-Brusatte

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

206 N Randolph St Ste 228
Champaign, IL 61820-3949

Phone

(765) 280-3032

NPI assigned

May 13, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Stephenie Austin-Brusatte LCSW PLLC

  • Adult Mental Health Clinic/Center
  • Champaign, IL
  • NPI 1902788169
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1356787741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 W OTTAWA RD",
            "city": "PAXTON",
            "state": "IL",
            "postal_code": "609574090",
            "telephone_number": "217-379-4302",
            "fax_number": "217-379-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N RANDOLPH ST STE 228",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203949",
            "telephone_number": "765-280-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN-BRUSATTE",
        "first_name": "STEPHENIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Athletico LTD (Athletico Sports Medicine and Physical Therapy)
• Bisola Elizabeth Atinsola, LSW
• Raya Atshan
• Cynthia Ann Aubry
• Alexandra Ausland
• Authentic Health Nutrition LLC
• Christin Kelly Avgar, LCSW
• Cassidy Awalt, MA
• Oluwatosin Hannah Ayo-Okuwobi
• Zoya Azam, MD

• Clinical Social Worker in Champaign, IL
• Providers in Champaign, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.