JACLYN ELAINE ALDRIDGE, MSW, LSW — NPI 1316112147 (Licensed & Credentialed Social Worker in URBANA, IL)

CMS-1500 Box 24J / 33a • NPI

1316112147

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

104100000X

Licensed & Credentialed Social Worker

Box 32 Service Location & ZIP+4

1109 S LINCOLN AVE, URBANA, IL, 61801-4703

✓ 9-Digit EDI 837 ZIP+4 (61801-4703)

Practice Phone & Referral Fax

(217) 333-2705

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1316112147 (JACLYN ELAINE ALDRIDGE, MSW, LSW) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1316112147` (NPI-1 Individual Practitioner)
Provider / Legal Name	JACLYN ELAINE ALDRIDGE, MSW, LSW
Plain-English Specialty	Licensed & Credentialed Social Worker NUCC Code: `104100000X` (Social Worker)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1109 S LINCOLN AVE, URBANA, IL, 61801-4703
Practice Telephone / Fax	Tel: (217) 333-2705
Administrative Mailing Address	604 W JOHN ST, CHAMPAIGN, IL, 61820-5812
Enumeration & Last Sync	Enumerated: 2008-04-23 \| CMS Record Updated: 2008-04-23

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1109 S LINCOLN AVE, URBANA, IL, 61801-4703

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Plain-English Taxonomy & CMS Crosswalk (104100000X)

What Does Taxonomy Code 104100000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 104100000X translates to:
"Licensed & Credentialed Social Worker"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Social Worker for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JACLYN ELAINE ALDRIDGE, MSW, LSW)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: IL \| License: `150.011456` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JACLYN ELAINE ALDRIDGE, MSW, LSW (NPI #1316112147)