Individual provider Active NPI

Emily Sue Purk, LCSW

  • Clinical Social Worker
  • Bloomington, IN
National Provider Identifier
1841946928
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33009087A Issued in IN
Practice address
482 S Landmark Ave
Bloomington, IN 47403-5000
Phone
(812) 333-8474
NPI assigned
Feb 26, 2022
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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 33009087A IN Primary

Addresses

Primary practice location

482 S Landmark Ave
Bloomington, IN 47403-5000

Mailing address

9747 E Sylvania Rd
Bloomfield, IN 47424-7105
Phone (812) 606-6370

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031000395 IN Practitioner - Clinical Social Worker 6103359013 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33009087AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Spencer PHD HSPP PC CurrentSince Oct 15, 2024 Accepting new patients

Locations

482 S Landmark Ave
Bloomington, IN 47403
Phone (812) 333-8474

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1841946928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9747 E SYLVANIA RD",
            "city": "BLOOMFIELD",
            "state": "IN",
            "postal_code": "474247105",
            "telephone_number": "812-606-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035000",
            "telephone_number": "812-333-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURK",
        "first_name": "EMILY",
        "middle_name": "SUE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-26",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "33009087A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.