Active NPI
Cassandra Croussore, LCSW
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1699550095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34012885A
- Practice address
- 1002 Wishard Blvd Ste 2001
Indianapolis, IN 46202-4164 - Phone
- (317) 944-2801
- NPI assigned
- Aug 25, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 34012885A | IN | Primary |
Addresses
Primary practice location
1002 Wishard Blvd Ste 2001
Indianapolis, IN 46202-4164
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
1809 S Main St Ste 100
Upland, IN 46989-9258
Phone (765) 770-0650
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699550095 | Other | IN | ANTHEM PTAN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | CCROUSSORE@DIRECT.IUHEALTH.ORG | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260620000066 | IN | Practitioner - Clinical Social Worker | 7113490228 |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
250 N Shadeland Ave
Indianapolis, IN 46219-4959
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1699550095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 WISHARD BLVD STE 2001",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462024164",
"telephone_number": "317-944-2801"
}
],
"practiceLocations": [
{
"address_1": "1809 S Main St Ste 100",
"address_purpose": "LOCATION",
"city": "Upland",
"state": "IN",
"postal_code": "469899258",
"country_code": "US",
"telephone_number": "765-770-0650",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CROUSSORE",
"first_name": "CASSANDRA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-25",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34012885A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PTAN",
"identifier": "1699550095",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "CCROUSSORE@DIRECT.IUHEALTH.ORG",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1002 Wishard Blvd Ste 2001",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462024164",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.