Lisa M Fox, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.022071 Issued in IL

Practice address

4460 N Illinois St Ste 1
Swansea, IL 62226-1899

Phone

(618) 277-7570

NPI assigned

Apr 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Blue Chair Counseling LLCGroup PAC ID 2163964594, 3 clinicians

Fortitude Trails CounselingGroup PAC ID 8921414947, 3 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.

• Blue Chair Counseling LLC

  • Clinical Social Worker
  • Maryville, IL
  • NPI 1336914142
  Medicare reassignment Care Compare group NPD Authorized official
• Fortitude Trails Counseling

  • Clinical Social Worker
  • Swansea, IL
  • NPI 1295327575
  Medicare reassignment Care Compare group NPD Authorized official
• Chestnut Health Systems Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bloomington, IL
  • NPI 1366431686
  Medicare reassignment NPD
• Chestnut Health Systems Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wood River, IL
  • NPI 1235941311
  NPD

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1184244261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 MARYVILLE RD STE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625400",
            "telephone_number": "618-484-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 N ILLINOIS ST STE 1",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622261899",
            "telephone_number": "618-277-7570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2921 Maryville Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620625400",
            "country_code": "US",
            "telephone_number": "618-484-9337",
            "fax_number": "618-484-9353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thea C Flock, D.C.
• Amy Forbeck
• Audrey Geneva Ford
• Kiesha Ford, MA, LPC
• Fortitude Trails Counseling
• Frank Scott Parkway Family Dental, LLC
• Frank Scott Parkway PC
• Ashley Fraser
• Jasmine Fulton, LSW
• Terri Denise Furfaro, DNP,APN,FNP-BC

• Clinical Social Worker in Swansea, IL
• Providers in Swansea, 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 28, 2023; 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.