Laurie L. Eastman, LCSW, SAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7805-123 Issued in WI

Practice address

903 Mineral Point Ave
Janesville, WI 53548-2970

Phone

(608) 756-6530

Fax

(608) 756-6564

NPI assigned

Feb 15, 2016

Last updated

Apr 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• Laurie L Marquis Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Social Worker

Education

Loyola University of Chicago, Stritch School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mercy Health System Corporation

  dba MHS Physician Services

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment Care Compare group NPD
• Mercy Health System Corporation

  dba Mercy Walworth Hospital and Medical Center

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1942669346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482970",
            "telephone_number": "608-756-6530",
            "fax_number": "608-756-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482970",
            "telephone_number": "608-756-6530",
            "fax_number": "608-756-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "LAURIE",
        "middle_name": "L.",
        "credential": "LCSW, SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16306-131",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7805-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSWI",
            "identifier": "1942669346",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942669346",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "701839",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI MEDICARE",
            "identifier": "000084908-K400277773",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEANHEALTH PLAN",
            "identifier": "1942669346",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "MARQUIS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan Francis Dunphy, D.C.
• Shane M Durkes, MD
• Dva Renal Healthcare Inc (Janesville Dialysis)
• Brandi Dye, COTA, OTR
• Jamee Lorraine Eanes
• Deanne K Eccles Rotar, MD
• Harlan D Edelman, MD
• Jeremy Edge, APSW
• Madison Egan
• Adrienne Jones Elert, PA-C

• Clinical Social Worker in Janesville, WI
• Providers in Janesville, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.