Individual provider Active NPI

Stephanie Cruwys, LCSW

  • Clinical Social Worker
  • Brunswick, GA
National Provider Identifier
1841302247
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW003287 Issued in GA
Practice address
600 G St Ste 6
Brunswick, GA 31520-6727
Phone
(912) 265-2055
Fax
(912) 265-2509
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW003287 GA Primary

Addresses

Primary practice location

600 G St Ste 6
Brunswick, GA 31520-6727

Mailing address

PO Box 2727
Brunswick, GA 31521-2727
Phone (912) 265-2055

Other identifiers 1

IdentifierTypeStateIssuer
851663137AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040629000513 GA Practitioner - Clinical Social Worker 4981680725 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Second Chance, Inc Clinical CurrentSince Jan 1, 2007 Accepting new patients

Locations

707 F St
Brunswick, GA 31520
Phone (912) 265-2055

600 G St
Ste 6
Brunswick, GA 31520
Phone (912) 265-2055

208 E 4th St
Woodbine, GA 31569
Phone (912) 265-2055

Organizations & group practices 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1841302247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2727",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315212727",
            "telephone_number": "912-265-2055",
            "fax_number": "912-265-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 G ST STE 6",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315206727",
            "telephone_number": "912-265-2055",
            "fax_number": "912-265-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUWYS",
        "first_name": "STEPHANIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "851663137A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.