Individual provider Active NPI

Angela Caraway, LCSW

  • Clinical Social Worker
  • Kirksville, MO
National Provider Identifier
1376682534
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2000161338 Issued in MO
Practice address
105 Pfeiffer Ave
Kirksville, MO 63501-5047
Phone
(660) 665-4612
NPI assigned
Feb 5, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 2000161338 MO Primary

Addresses

Primary practice location

105 Pfeiffer Ave
Kirksville, MO 63501-5047

Mailing address

917 Broadway
PO Box 708
Hannibal, MO 63401-4200
Phone (573) 221-2120

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040806001119 MO Practitioner - Clinical Social Worker 5092787432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

105 Pfeiffer Ave
Kirksville, MO 63501-5047
Phone (660) 665-4612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2000161338MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Twain Association for Mental Health, Inc CurrentSince Apr 9, 2018 Accepting new patients
Mark Twain Association for Mental Health, Inc. CurrentSince Apr 9, 2018 Accepting new patients

Locations

154 Forrest Dr
Hannibal, MO 63401
Phone (573) 221-2120

917 Broadway
Hannibal, MO 63401
Phone (573) 221-2120

105 Pfeiffer Ave
Kirksville, MO 63501
Phone (660) 627-5757

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376682534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 BROADWAY",
            "address_2": "PO BOX 708",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634014200",
            "telephone_number": "573-221-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PFEIFFER AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635015047",
            "telephone_number": "660-665-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARAWAY",
        "first_name": "ANGELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2000161338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.