NPIMap

Organization Active NPI

Crystal Clear Behavioral Health Services

Doing business as Tamara Fields, LCSW

  • Clinical Social Worker
  • Homewood, IL
National Provider Identifier
1114366531
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014385 Issued in IL
Legal business name
CRYSTAL CLEAR BEHAVIORAL HEALTH SERVICES
Doing business as
Tamara Fields, LCSW
Practice address
1818 Ridge Road
Unit 104
Homewood, IL 60430-1763
Phone
(708) 275-0937
Fax
(815) 521-1889
NPI assigned
Jun 19, 2013
Last updated
Nov 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Authorized official

Name
Tamara Fields, LCSWNPI 1962743328
Title
Owner
Phone
(708) 275-0937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.014385 IL Primary

Addresses

Primary practice location

1818 Ridge Road
Unit 104
Homewood, IL 60430-1763

Mailing address

4304A E Central Texas Expy Ste a
Killeen, TX 76543-7308
Phone (708) 275-0937

Other names 1

  • Tamara Fields, LCSW Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1114366531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304A E CENTRAL TEXAS EXPY STE A",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765437308",
            "telephone_number": "708-275-0937",
            "fax_number": "708-310-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 RIDGE ROAD",
            "address_2": "UNIT 104",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301763",
            "telephone_number": "708-275-0937",
            "fax_number": "815-521-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CLEAR BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-19",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-275-0937",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tamara Fields, LCSW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tamara Fields, LCSW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.