Neil C. Headman, PHD, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.011848 Issued in IL

Practice address

2534 Farragut Dr Ste 2
Springfield, IL 62704

Phone

(217) 953-4660

Fax

(888) 972-6419

NPI assigned

Jun 1, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 20, 2020 through Jan 20, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Wellspring Counseling, LLC

  • Clinical Social Worker
  • Springfield, IL
  • NPI 1568892875

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1407058415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 FARRAGUT DR STE 2",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041466",
            "telephone_number": "217-953-4660",
            "fax_number": "888-972-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 FARRAGUT DR STE 2",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62704",
            "telephone_number": "217-953-4660",
            "fax_number": "888-972-6419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 S Durkin Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627041386",
            "country_code": "US",
            "telephone_number": "217-494-7546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEADMAN",
        "first_name": "NEIL",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly R Haywood, CRNA
• Kevin D. Hazard, M.D.
• Hazel Mackey Center
• Stephen R Hazelrigg, M.D.
• Bryanna R Hea, LSW
• Patricia W. Headman
• Healing Compass Therapy PLLC
• Healing Emotions Mental Health Services PLLC
• Healing Pathways of Springfield, Inc.
• Healthcare Network Associates

• All providers in Springfield, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.