Individual provider Active NPI

Beth Anne Vogel, LCSW

  • Clinical Social Worker
  • Bloomington, IL
National Provider Identifier
1083586606
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.029574 Issued in IL
Practice address
2810 Degarmo Dr
Bloomington, IL 61704-9101
Phone
(309) 310-6465
NPI assigned
Sep 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.029574 IL Primary

Addresses

Primary practice location

2810 Degarmo Dr
Bloomington, IL 61704-9101

Mailing address

2810 Degarmo Dr
Bloomington, IL 61704-9101
Phone (309) 310-6465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.029574ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1083586606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 DEGARMO DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617049101",
            "telephone_number": "309-310-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 DEGARMO DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617049101",
            "telephone_number": "309-310-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGEL",
        "first_name": "BETH",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.029574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.