Active NPI
Janice Benedict, LCSW
- Clinical Social Worker
- Rockford, IL
National Provider Identifier
1174896765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149017083
- Practice address
- 6975 Redansa Dr
Rockford, IL 61108-1201 - Phone
- (815) 398-7000
- NPI assigned
- Feb 14, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149017083 | IL | Primary |
Addresses
Primary practice location
6975 Redansa Dr
Rockford, IL 61108-1201
Mailing address
3710 Corbridge LN
Rockford, IL 61107-3548
Phone (815) 986-1113
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149017083 | Other | IL | STATE LICENSE |
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinic of Psychiatric Care | Past | Accepting new patients | |
| Progressive Chiropractic Wellness & Rehab Centre, P.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Loves Park, IL
- NPI 1659531549
-
- Point of Service
- Loves Park, IL
- NPI 1023206265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612310400000",
"number": "1174896765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3710 CORBRIDGE LN",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611073548",
"telephone_number": "815-986-1113",
"fax_number": "815-986-1119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6975 REDANSA DR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611081201",
"telephone_number": "815-398-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENEDICT",
"first_name": "JANICE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-14",
"last_updated": "2021-02-03",
"certification_date": "2021-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149017083",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "149017083",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.