Individual provider Active NPI

Brittany Leanne McCrady

  • Social Worker
  • Alton, IL
National Provider Identifier
1760760433
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
2615 Edwards St
Alton, IL 62002-3915
Phone
(618) 462-2331
Fax
(618) 462-7160
NPI assigned
Jul 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.017405 IL
Social Worker 104100000X Primary

Addresses

Primary practice location

2615 Edwards St
Alton, IL 62002-3915

Mailing address

902 W Main St
West Frankfort, IL 62896-2210
Phone (618) 937-6483

Other names 1

  • Brittany Leanne Thatcher Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151207002666 IL Practitioner - Clinical Social Worker 3779883194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerstone of Illinois IncGroup PAC ID 2961545173, 44 clinicians

Practice addresses (Care Compare)

2615 Edwards St
Alton, IL 62002-3915
Phone (618) 462-2331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017405ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Illinois, Inc CurrentSince Dec 1, 2015 Accepting new patients
Centerstone of Illinois, Inc CurrentSince Dec 1, 2015 Accepting new patients

Locations

2615 Edwards St
Alton, IL 62002
Phone (618) 462-2331

902 W Main St
West Frankfort, IL 62896
Phone 6189376483 ext. 7565

Organizations & group practices 3

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": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1760760433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-937-6483",
            "fax_number": "618-937-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 EDWARDS ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023915",
            "telephone_number": "618-462-2331",
            "fax_number": "618-462-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRADY",
        "first_name": "BRITTANY",
        "middle_name": "LEANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017405",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "THATCHER",
            "middle_name": "LEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.