Active NPI
Merrill Dell Crandall, MSW
- Clinical Social Worker
- Grand Island, NE
National Provider Identifier
1790713659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 711
- Practice address
- 2201 N Broadwell Ave
Grand Island, NE 68803-2153 - Phone
- (308) 382-3660
- Fax
- (308) 389-5126
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- 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 | 711 | NE | Primary |
Addresses
Primary practice location
2201 N Broadwell Ave
Grand Island, NE 68803-2153
Mailing address
2201 N Broadwell Ave
Grand Island, NE 68803-2153
Phone (308) 382-3660
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790713659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 N BROADWELL AVE",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688032153",
"telephone_number": "308-382-3660",
"fax_number": "308-389-5126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 N BROADWELL AVE",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688032153",
"telephone_number": "308-382-3660",
"fax_number": "308-389-5126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDALL",
"first_name": "MERRILL",
"middle_name": "DELL",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.