Active NPI
Patrick Joseph Garrison, LCSW
- Clinical Social Worker
- Belleville, IL
National Provider Identifier
1619417086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.010330
- Practice address
- 949 Stone Creek LN
Belleville, IL 62223-2654 - Phone
- (618) 569-9048
- NPI assigned
- Mar 3, 2017
- Last updated
- Mar 3, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.010330 | IL | Primary |
Addresses
Primary practice location
949 Stone Creek LN
Belleville, IL 62223-2654
Mailing address
949 Stone Creek LN
Belleville, IL 62223-2654
Phone (618) 569-9048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.010330 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488499200000",
"number": "1619417086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "949 STONE CREEK LN",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622232654",
"telephone_number": "618-569-9048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "949 STONE CREEK LN",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622232654",
"telephone_number": "618-569-9048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRISON",
"first_name": "PATRICK",
"middle_name": "JOSEPH",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-03",
"last_updated": "2017-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.010330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.