Active NPI
Eileen C. Scrivner, LCSW, ACSW
- Clinical Social Worker
- Madison, WI
National Provider Identifier
1376755496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6605-123
- Practice address
- 1008 Fish Hatchery Road
Madison, WI 53715 - Phone
- (608) 260-9466
- Fax
- (608) 260-9467
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6605-123 | WI | Primary |
Addresses
Primary practice location
1008 Fish Hatchery Road
Madison, WI 53715
Mailing address
N9094 Legler Road
Brooklyn, WI 53521
Phone (608) 455-1722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6605-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Symphony Diagnostic Services No 1 LLC | Past | Accepting new patients | |
| Symphony Diagnostic Services No 1 LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
dba MobilexUSA
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Hunt Valley, MD
- NPI 1700865094
-
dba MobilexUSA
- Physiological Laboratory
- Clearwater, FL
- NPI 1932376233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1376755496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N9094 LEGLER ROAD",
"city": "BROOKLYN",
"state": "WI",
"postal_code": "53521",
"telephone_number": "608-455-1722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 FISH HATCHERY ROAD",
"city": "MADISON",
"state": "WI",
"postal_code": "53715",
"telephone_number": "608-260-9466",
"fax_number": "608-260-9467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCRIVNER",
"first_name": "EILEEN",
"middle_name": "C.",
"name_prefix": "Mrs.",
"credential": "LCSW, ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "6605-123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.