Susan L Ecker, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Maryville, MO

NPI 1386765576 · NPPES record last updated May 26, 2016

Key facts

NPI
1386765576
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2007005136 (MO)
Practice address
2416 S Main St
Maryville, MO 64468-3624
Phone
(660) 562-2352
Fax
(660) 562-2933
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Waubonsie Mental Health Center Inc (6 clinicians)

Practice addresses (Care Compare)

216 W Division St
Clarinda, IA 51632-2509
Phone (712) 542-2388

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120221000477 IA Practitioner - Clinical Social Worker 2163529462 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2007005136MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Waubonsie Mental Health Center Inc Current
since Jan 24, 2012
Accepting new patients

Locations

216 W Division St
Clarinda, IA 51632
Phone (712) 542-5676

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2007005136 MO Yes

Addresses

Primary practice location

2416 S Main St
Maryville, MO 64468-3624

Mailing address

11334 Bobcat Rd
Elmo, MO 64445-8135
Phone (660) 742-3416

Other providers in Maryville, MO

All providers in Maryville, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.