Ann Christine Crumpler, MSSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149009064 Issued in IL

Practice address

2500 W Reynolds St
Suite 207 St. James Hospital, Psychology Specialists
Pontiac, IL 61764-9774

Phone

(815) 579-9002

Fax

(309) 588-4115

NPI assigned

Jul 29, 2009

Last updated

Apr 30, 2010By 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

Not listed in the public Medicare enrollment file

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.

Specialty

Clinical Social Worker

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.anncrumpler@146897.advancedmd-direct.com

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.

• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Clinical

  NPD

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272585600000",
    "number": "1629209432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604",
            "address_2": "PSYCHOLOGY SPECIALISTS LTD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617020604",
            "telephone_number": "309-706-3190",
            "fax_number": "309-452-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W REYNOLDS ST",
            "address_2": "SUITE 207 ST. JAMES HOSPITAL, PSYCHOLOGY SPECIALISTS",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649774",
            "telephone_number": "815-579-9002",
            "fax_number": "309-588-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMPLER",
        "first_name": "ANN",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "MSSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2010-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia Diane Conlisk, M.S.CCC-SLP/L
• William Edward Copes, BADC
• Julia Eileen Cotter, PEL
• Creamean Chiropractic Clinic
• Terry Lee Creamean
• Joan Curry
• James A Day, DDS
• Brittany Ann Delaney, ATC
• Dialysis Centers of America - Illinois, Inc. (RCG Central Illinois-Pontiac)
• Elizabeth Diemer

• Clinical Social Worker in Pontiac, IL
• Providers in Pontiac, 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 Apr 30, 2010; 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.