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DYNAMIC COUNSELING AND CONSULTATION SERVICES
NPI 1457771677
Social Worker - Clinical in Mount Vernon, IL

Active since April 27, 2014
4202 WILLIAMSON PL STE 1, MOUNT VERNON, IL 62864(618) 816-1224(800) 335-4761 Get Directions Write a Review

NPPES record last updated: January 27, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dynamic Counseling And Consultation Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DYNAMIC COUNSELING AND CONSULTATION SERVICES (NPI 1457771677) is a healthcare organization registered as a clinical in Mount Vernon, Illinois and active in the NPI registry since April 2014. The organization lists Carrie Crocker, Owner, as its authorized official.

NPPES Registry Identity

NPI1457771677
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameDYNAMIC COUNSELING AND CONSULTATION SERVICES
Location Address4202 WILLIAMSON PL STE 1Mount Vernon, IL 62864-6760
Mailing Address1111 S Lincoln Ave Unit 1326O Fallon, IL 62269-5165 · (618) 816-1224 · Fax (800) 335-4761
Phone(618) 816-1224
Fax(800) 335-4761
Organization SubpartNo
Authorized OfficialCarrie CrockerOwner · (618) 816-1224
Enumeration DateApril 27, 2014
Last NPPES UpdateJanuary 27, 2025
NPPES CertifiedJanuary 27, 2025
✔ NPI 1457771677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MO · 2003032196
Definition
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.
4202 WILLIAMSON PL STE 1, Mount Vernon, IL 62864
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Other Identifiers 1

Medicaid497312108MO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dynamic Counseling And Consultation Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Dynamic Counseling And Consultation Services, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Carrie Crocker, MSW, LCSW
Clinical Social Worker
NPI 1972657187
4202 WILLIAMSON PL STE 1
Mount Vernon, IL 62864
(618) 816-1224
✔ PECOS✔ Accepts MedicareSame address
Tiffany Shurtz, MSW, LCSW
Clinical Social Worker
NPI 1467112417
119 GAS PLANT RD
Du Quin, IL 62832
(618) 790-2146
✔ PECOS✔ Accepts Medicare27 mi
Tiffany Blasdel
Clinical Social Worker
NPI 1376234831
424 COUNTY ROAD 1350 N
Wayne City, IL 62895
(618) 899-0327
✔ PECOS✔ Accepts Medicare50 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dynamic Counseling And Consultation Services's NPI number?

The NPI number for Dynamic Counseling And Consultation Services is 1457771677. It was assigned to this organization in the NPPES registry on April 27, 2014.

Where is Dynamic Counseling And Consultation Services located?

Dynamic Counseling And Consultation Services is located at 4202 Williamson Pl Ste 1, Mount Vernon, IL 62864. The listed phone number is (618) 816-1224.

What is Dynamic Counseling And Consultation Services's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Dynamic Counseling And Consultation Services enrolled in Medicare?

Yes. Dynamic Counseling And Consultation Services is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dynamic Counseling And Consultation Services?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Clinical Social Worker, reassign their Medicare billing to Dynamic Counseling And Consultation Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Dynamic Counseling And Consultation Services accept?

Health plans from Anthem Blue Cross and Blue Shield list Dynamic Counseling And Consultation Services as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dynamic Counseling And Consultation Services was last updated on January 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.