Individual provider Active NPI

Karolyn Ruth Rich, L.C.S.W.

  • Clinical Social Worker
  • Lockport, IL
National Provider Identifier
1093842890
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.006600 Issued in IL
Practice address
217 Bruce Rd.
Lockport, IL 60441-4906
Phone
(773) 307-7205
Fax
(815) 714-6244
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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 149.006600 IL Primary

Addresses

Primary practice location

217 Bruce Rd.
Lockport, IL 60441-4906

Mailing address

217 Bruce Rd.
Lockport, IL 60441-4906
Phone (773) 307-7205

Other identifiers 1

IdentifierTypeStateIssuer
20150720920191MedicaidIL

Other names 1

  • Karolyn Ruth Stanek Former name

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
149.006600ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1093842890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 BRUCE RD.",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604414906",
            "telephone_number": "773-307-7205",
            "fax_number": "815-714-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 BRUCE RD.",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604414906",
            "telephone_number": "773-307-7205",
            "fax_number": "815-714-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "KAROLYN",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.006600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20150720920191",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAROLYN",
            "last_name": "STANEK",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lockport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.