Individual provider Active NPI

Carly Schrimpl, LCSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1487005989
Registry record updated Jun 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018418 Issued in IL
Practice address
25W661 Indian Hill Woods
Naperville, IL 60563-1468
Phone
(630) 803-3286
NPI assigned
Jun 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2016

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 149018418 IL Primary

Addresses

Primary practice location

25W661 Indian Hill Woods
Naperville, IL 60563-1468

Mailing address

25W661 Indian Hill Woods
Naperville, IL 60563-1468
Phone (630) 803-3286

Other identifiers 1

IdentifierTypeStateIssuer
1041C0700XMedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 31, 2024 through May 31, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149018418ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Power Within Counseling CurrentSince Mar 17, 2024 Accepting new patients

Locations

3325 N University Ave
Ste 250
Provo, UT 84604
Phone (435) 239-3517

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": "1466899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466899200000",
    "number": "1487005989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25W661 INDIAN HILL WOODS",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631468",
            "telephone_number": "630-803-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25W661 INDIAN HILL WOODS",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631468",
            "telephone_number": "630-803-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRIMPL",
        "first_name": "CARLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-26",
        "last_updated": "2016-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.