August Supan, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-007817 Issued in IL

Practice address

750 Broadway Ave E
Mattoon, IL 61938-4610

Phone

(217) 238-5700

Fax

(217) 238-5767

NPI assigned

Oct 4, 2006

Last updated

Aug 4, 2015By the provider in NPPES

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

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

Specialty

Clinical Social Worker

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Coles County Mental Health Association IncGroup PAC ID 9537194329, 6 clinicians

Practice addresses (Care Compare)

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.

• Coles County Mental Health Association, Inc.

  dba LifeLinks Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mattoon, IL
  • NPI 1942203914
  Medicare reassignment Care Compare group NPD
• Coles County Mental Health Association, Inc

  dba LifeLinks Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Effingham, IL
  • NPI 1841738283
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1598851040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BROADWAY AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384610",
            "telephone_number": "217-238-5700",
            "fax_number": "217-238-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BROADWAY AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384610",
            "telephone_number": "217-238-5700",
            "fax_number": "217-238-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPAN",
        "first_name": "AUGUST",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-007817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Stuenke
• Sathya Subbiah, M.D.
• Claire Sullivan, BA
• Priscilla Jane Sullivan, MHP
• Marci Elaine Summers, CCC-SLP
• Michelle Switzer
• Leslie A Taggart, APN
• Kyle Justin Tam, BS
• Nehemiah T Tan, M.D.
• Kathryn E Tanner, MD

• Clinical Social Worker in Mattoon, IL
• Providers in Mattoon, 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 Aug 4, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.