Shirley Marie Forcum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.020198 Issued in IL

Practice address

10257 State Route 3
Red Bud, IL 62278-4418

Phone

(618) 282-6233

NPI assigned

Jan 23, 2023

Last updated

Jan 23, 2023By the provider in NPPES

Sex

Female

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

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comwell

  • Developmentally Disabled Services Day Training Agency
  • Red Bud, IL
  • NPI 1134199037

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1457067506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604",
            "city": "TILDEN",
            "state": "IL",
            "postal_code": "622920604",
            "telephone_number": "618-317-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10257 STATE ROUTE 3",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622784418",
            "telephone_number": "618-282-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORCUM",
        "first_name": "SHIRLEY",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charmaine E Edwards, M.D.
• Pamela Elizabeth Ehlers, BS
• Jeremy Ryan Fletcher, SSP, NCSP
• Kaitlin Floarke, OTR/L
• Focus Rehabilitation
• Samantha Garza
• Gibson's Discount Drugs, Inc (Gibson's Discount Drugs)
• Viki Goodnick, LCPC
• Groceries of Southern Illinois, LLC. (Red Bud Country Mart Pharmacy)
• Emily Grossmann

• Clinical Social Worker in Red Bud, IL
• Providers in Red Bud, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.