Individual provider Active NPI

Sebin Jose

  • Clinical Social Worker
  • Camp Lejeune, NC
National Provider Identifier
1457190332
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149026616 Issued in IL
Practice address
100 Brewster Blvd
Camp Lejeune, NC 28547-2538
Phone
(910) 450-4357
NPI assigned
May 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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 149026616 IL Primary

Addresses

Primary practice location

100 Brewster Blvd
Camp Lejeune, NC 28547-2538

Mailing address

100 Brewster Blvd
Camp Lejeune, NC 28547-2538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240716002341 IL Practitioner - Clinical Social Worker 1557806460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thriveworks Clinical - IllinoisGroup PAC ID 6800263823, 45 clinicians

Practice addresses (Care Compare)

1051 Essington Rd
Suite 280
Joliet, IL 60435-2808
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149026616ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Illinois CurrentSince Jun 18, 2024 Accepting new patients

Locations

333 N Michigan Ave
Ste 1810
Chicago, IL 60601
Phone (217) 850-1133

1051 Essington Rd
Ste 280
Joliet, IL 60435
Phone (217) 850-1133

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1457190332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSE",
        "first_name": "SEBIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-21",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149026616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

Verify at the official NPI Registry.