Individual provider Active NPI

Lauren Leigh Barris, LCSW

  • Clinical Social Worker
  • Springfield, IL
National Provider Identifier
1093224024
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149022271 Issued in IL
Practice address
2501 Chatham Rd Ste N
Springfield, IL 62704-4188
Phone
(616) 328-6109
Fax
(616) 328-6529
NPI assigned
Sep 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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 149022271 IL Primary

Addresses

Primary practice location

2501 Chatham Rd Ste N
Springfield, IL 62704-4188

Mailing address

625 Kenmoor Ave SE Ste 301
Grand Rapids, MI 49546-2395
Phone (616) 328-6109

Other practice location 1

625 Kenmoor Ave SE Ste 301
Grand Rapids, MI 49546-2395
Phone (616) 328-6109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Nov 1, 2019 through Nov 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149022271ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Dialectical Behavior Therapy, LLC Clinical Current Accepting new patients

Locations

2501 Chatham Rd
Ste N
Springfield, IL 62704
Phone (773) 250-7404

625 Kenmoor Ave SE
Ste 301
Grand Rapids, MI 49546
Phone (231) 519-8300

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1093224024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 301",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395",
            "telephone_number": "616-328-6109",
            "fax_number": "616-328-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE N",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "616-328-6109",
            "fax_number": "616-328-6529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Kenmoor Ave SE Ste 301",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495462395",
            "country_code": "US",
            "telephone_number": "616-328-6109",
            "fax_number": "616-328-6529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRIS",
        "first_name": "LAUREN",
        "middle_name": "LEIGH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-21",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149022271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.