MR. CHARLES RUSSELL KERWIN (NPI# 1063706497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063706497 |
| Entity Type | Individual |
| Full Name | MR. CHARLES RUSSELL KERWIN |
| Credential | LCSW, CADC |
| Practice Address |
1770 Elake Shore Dr Decatur IL 62521-3832 |
| Mailing Address |
1770 East Lake Shore Dr Decatur IL 62521 |
| Practice Telephone | 2174281900 |
| Mailing Telephone | 2174281900 |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2011-06-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.014464 | IL | Behavioral Health & Social Service Providers |
| Street Address |
1770 ELAKE SHORE DR |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-3832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922613785 | Healing Minds, Helping Hearts, LLC | Social Worker | 2532 N Decatur Rd, Apt 1304, Decatur, GA 30033 | 2020-09-09 |
| 1750999710 | Torquesia Smith | Social Worker | 3904 N Druid Hills Rd Ste 243, Decatur, GA 30033-3105 | 2020-07-16 |
| 1760002836 | Renee Ann Hall-george | Social Worker | 235 E Ponce De Leon Ave Ste 227, Decatur, GA 30030-3412 | 2020-04-19 |
| 1831721067 | Shelly-anne Johnson | Social Worker | 2205 Green Forrest Dr, Decatur, GA 30032-7165 | 2020-02-05 |
| 1871130096 | Mark Loren Kiefer | Social Worker | 2719 Mount Olive Dr, Decatur, GA 30033-2928 | 2019-12-06 |
| 1639715782 | Nadine Coleen Oldham | Social Worker | 2785 Lawrenceville Hwy Ste 205, Decatur, GA 30033-2515 | 2019-11-25 |
| 1881235133 | Marybeth Ann Peters | Social Worker | 1457 Clairmont Rd, Decatur, GA 30033-5362 | 2019-10-07 |
| 1720635782 | Caitlin Virginia Rattigan | Social Worker | 245 E Trinity Pl Unit 1260, Decatur, GA 30030-3487 | 2019-08-23 |
| 1700448644 | Danna Lipton | Social Worker | 209a Swanton Way Ste 102, Decatur, GA 30030-3271 | 2019-07-01 |
| 1023673647 | Candace E Guthery | Social Worker | 16 Moulton St E, Decatur, AL 35601-2310 | 2019-05-08 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.