NPIMap

Individual provider Active NPI

Elizabeth S Carriker, LCSW

  • Clinical Social Worker
  • Decatur, IL
National Provider Identifier
1366195331
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149024170 Issued in IL
Practice address
102 W Kenwood Ave Ste 100
Decatur, IL 62526-4379
Phone
(217) 872-3800
Fax
(217) 872-0849
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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 149024170 IL Primary

Addresses

Primary practice location

102 W Kenwood Ave Ste 100
Decatur, IL 62526-4379

Mailing address

201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000

Other practice location 1

710 N 8th St
Springfield, IL 62702-6324
Phone (217) 525-1064

Other identifiers 1

IdentifierTypeStateIssuer
149024170OtherILLCSW LICENSE

Other names 1

  • Elizabeth S Tumiati Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220209002343 IL Practitioner - Clinical Social Worker 9436542743 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Board of Trustees of Southern Illinois UniversityGroup PAC ID 4486667888, 139 clinicians

Practice addresses (Care Compare)

102 W Kenwood Ave
Suite 100
Decatur, IL 62526-4379
Phone (217) 872-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University CurrentSince May 20, 2024 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince May 20, 2024 Accepting new patients
Mental Health Centers of Central Illinois Clinical CurrentSince Nov 5, 2023 Accepting new patients

Locations

102 W Kenwood Ave
Ste 100
Decatur, IL 62526
Phone (217) 872-3800

901 N 1st St
Ste 225
Springfield, IL 62702
Phone (217) 523-2217

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

3225 Hedley Rd
Springfield, IL 62711
Phone (217) 726-6700

Organizations & group practices 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1366195331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST STE 328",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W KENWOOD AVE STE 100",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264379",
            "telephone_number": "217-872-3800",
            "fax_number": "217-872-0849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 N 8th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627026324",
            "country_code": "US",
            "telephone_number": "217-525-1064",
            "fax_number": "217-525-1651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRIKER",
        "first_name": "ELIZABETH",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149024170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE",
            "identifier": "149024170",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "TUMIATI",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.