Active NPI
Andrea S. Cruse, LCSW
- Clinical Social Worker
- Mount Carmel, IL
National Provider Identifier
1790061638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.014829
- Practice address
- 1001 N Market St
Suite 101
Mount Carmel, IL 62863-1945 - Phone
- (618) 263-4970
- NPI assigned
- Oct 24, 2011
- Last updated
- Aug 2, 2012
- 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 | 149.014829 | IL | Primary |
Addresses
Primary practice location
1001 N Market St
Suite 101
Mount Carmel, IL 62863-1945
Mailing address
106 Perry St
Mount Carmel, IL 62863-2579
Phone (618) 263-2134
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 |
|---|---|---|---|
| 149.014829 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343865600000",
"number": "1790061638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 PERRY ST",
"city": "MOUNT CARMEL",
"state": "IL",
"postal_code": "628632579",
"telephone_number": "618-263-2134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 N MARKET ST",
"address_2": "SUITE 101",
"city": "MOUNT CARMEL",
"state": "IL",
"postal_code": "628631945",
"telephone_number": "618-263-4970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUSE",
"first_name": "ANDREA",
"middle_name": "S.",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-24",
"last_updated": "2012-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.014829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Carmel, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.