MRS. BETSY VAN BROCKLIN (NPI# 1649537747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649537747 |
| Entity Type | Individual |
| Full Name | MRS. BETSY VAN BROCKLIN |
| Credential | MSW |
| Practice Address |
340 W State St Jacksonville IL 62650-2061 |
| Mailing Address |
710 N 8th St Springfield IL 62702-6324 |
| Practice Telephone | 2172456126 |
| Practice Fax Number | 2172454296 |
| Mailing Telephone | 2175251064 |
| Mailing Fax Number | 2175251651 |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2014-01-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149016387 | IL | Behavioral Health & Social Service Providers |
| Street Address |
340 W STATE ST |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-2061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437128006 | Kathy Moore Dyson | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2006-03-16 |
| 1629694583 | Elizbeth Huss Secrist | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2020-06-17 |
| 1063058113 | Nora A Bishop | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2019-11-25 |
| 1538644646 | Misty Dawn Spencer | Social Worker | 340 W State St, Jacksonville, IL 62650-2061 | 2018-09-25 |
| 1699253815 | Teegan Rochelle Lund | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2018-07-31 |
| 1013401322 | Mental Health Centers of Central Illinois | Clinic/Center | 340 W State St, Jacksonville, IL 62650-2061 | 2018-06-20 |
| 1558736959 | Christina L. Meads | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2015-12-10 |
| 1164856407 | Yoli S Holmes | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2013-08-22 |
| 1972887156 | Debra K Webb | Social Worker | 340 W State St, Jacksonville, IL 62650-2061 | 2011-10-05 |
| 1225282999 | Mental Health Centers of Central Illinois | Clinic/Center | 340 W State St, Jacksonville, IL 62650 | 2008-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| 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 |
|---|---|---|---|---|
| 1336748193 | Sophia Venditti | Social Worker | 2598 Post St # 1, Jacksonville, FL 32204-4256 | 2020-10-22 |
| 1629676093 | My Journey, LLC | Social Worker | 13453 N Main St Ste 204, Jacksonville, FL 32218-2773 | 2020-10-16 |
| 1104423524 | Sonya Young | Social Worker | 920 Bridier St, Jacksonville, FL 32206-5904 | 2020-10-08 |
| 1043823115 | Sierra Lashonda Murray | Social Worker | 9246 Thunderbolt Dr, Jacksonville, FL 32221-8052 | 2020-08-28 |
| 1235741901 | Deidra Lewis | Social Worker | 4480 Deerwood Lake Pkwy Unit 134, Jacksonville, FL 32216-2255 | 2020-08-23 |
| 1497365456 | Darlene Denise Rolle- Cargill | Social Worker | 14050 Integra Dr Apt 420, Jacksonville, FL 32218-2592 | 2020-08-05 |
| 1689282626 | Andrea Kristin Perkinson | Social Worker | 128 Plow Point Ln, Jacksonville, NC 28546-9591 | 2020-07-15 |
| 1255956371 | Noel Roman | Social Worker | 11775 Carson Lake Dr W, Jacksonville, FL 32221-3812 | 2020-06-15 |
| 1285257535 | Phaith Coaching & Counseling, LLC | Social Worker | 4940 Emerson St, Jacksonville, FL 32207-4963 | 2020-05-21 |
| 1407478613 | Mara's Lighthouse Counseling Center, LLC | Social Worker | 6015 Morrow St E Ste 114, Jacksonville, FL 32217-2125 | 2020-05-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
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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.