Individual provider Active NPI

Judy Hillyer, LCSW

  • Clinical Social Worker
  • Ellisville, MO
National Provider Identifier
1396110144
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004709 Issued in MO
Practice address
210 Clarkson Executive Park
Ellisville, MO 63011-2165
Phone
(636) 295-6010
NPI assigned
Dec 4, 2015
Last updated
May 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

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 004709 MO Primary

Addresses

Primary practice location

210 Clarkson Executive Park
Ellisville, MO 63011-2165

Mailing address

10 Hillington CT
Eureka, MO 63025-1087
Phone (636) 295-6010

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
I20200519001530 MO Practitioner - Clinical Social Worker 6406287853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

210 Clarkson Executive Park
Ellisville, MO 63011-2165
Phone (636) 295-6010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004709MOMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Rooted Strategies Counseling, LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

210 Clarkson Executive Park
Ellisville, MO 63011
Phone (636) 295-6010

Organizations & group practices 1

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": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1396110144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HILLINGTON CT",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251087",
            "telephone_number": "636-295-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CLARKSON EXECUTIVE PARK",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112165",
            "telephone_number": "636-295-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLYER",
        "first_name": "JUDY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-04",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

Verify at the official NPI Registry.