Reginald Washington Edwards, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.022583 Issued in IL

Practice address

18660 Walnut Ave
Country Club Hills, IL 60478-5549

Phone

(708) 600-5752

NPI assigned

Nov 5, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Reginald Edwards Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452

  Clinical

  Medicare reassignment Care Compare group NPD
• Baal Perazim Wellness, Inc

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1215403530
  Medicare reassignment NPD
• Eaves Health Partners PLLC

  • Clinical Social Worker
  • Skokie, IL
  • NPI 1639847551
  Medicare reassignment NPD
• Great Changes Counseling Services, P.C.

  • Clinical Social Worker
  • Mokena, IL
  • NPI 1205137346
  Medicare reassignment NPD

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1174124036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18660 WALNUT AVE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604785549",
            "telephone_number": "708-600-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18660 WALNUT AVE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604785549",
            "telephone_number": "708-600-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "REGINALD",
        "middle_name": "WASHINGTON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "GMAIL",
            "affiliation": "N",
            "endpointDescription": "Social Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "18660 Walnut Ave",
            "city": "Country Club Hills",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604785549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "REGINALD",
            "last_name": "EDWARDS",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Social Worker in Country Club Hills, IL
• Providers in Country Club Hills, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.