Individual provider Active NPI

Elizabeth M Davy, LCSW

  • Clinical Social Worker
  • Yorkville, IL
National Provider Identifier
1184751802
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-004990 Issued in IL
Practice address
110 E Countryside Pkwy
Yorkville, IL 60560-1813
Phone
(630) 553-1600
Fax
(630) 553-7993
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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 149-004990 IL Primary

Addresses

Primary practice location

110 E Countryside Pkwy
Yorkville, IL 60560-1813

Mailing address

1120 E Main St
Ste. 201
St Charles, IL 60174-2287
Phone (630) 377-6613

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070418000323 IL Practitioner - Clinical Social Worker 9638274715 Practice locations: Sugar Grove, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Michigan Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

330 Division Dr J
Sugar Grove, IL 60554-9800
Phone (630) 391-2981

330 N Division Dr
Suite J
Sugar Grove, IL 60554-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-004990ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Counseling Center, PC PastSince Feb 1, 2007 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1184751802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST",
            "address_2": "STE. 201",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742287",
            "telephone_number": "630-377-6613",
            "fax_number": "630-377-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E COUNTRYSIDE PKWY",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601813",
            "telephone_number": "630-553-1600",
            "fax_number": "630-553-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVY",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-004990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorkville, IL

Sources for this page

Verify at the official NPI Registry.