Individual provider Active NPI

Ben Bernstein, LCSW

  • Clinical Social Worker
  • Champaign, IL
National Provider Identifier
1194156422
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018152 Issued in IL
Practice address
1813 W Kirby Ave Ste 120
Champaign, IL 61821-5410
Phone
(217) 383-1850
Fax
(217) 383-3439
NPI assigned
Dec 12, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 149018152 IL Primary

Addresses

Primary practice location

1813 W Kirby Ave Ste 120
Champaign, IL 61821-5410

Mailing address

611 W Park St
Urbana, IL 61801-2529
Phone (217) 383-6941

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
I20160219000013 IL Practitioner - Clinical Social Worker 3678878279 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Dulski Counseling, LLCGroup PAC ID 6608362736, 3 clinicians
Champaign Counseling LLCGroup PAC ID 9335429232, 3 clinicians

Practice addresses (Care Compare)

3362 Big Pine TRL
Suite a
Champaign, IL 61822-1409
Phone (217) 383-0151

7 Dunlap CT
Savoy, IL 61874-9501
Phone (217) 203-2008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149018152ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group CurrentSince Jun 5, 2017 Accepting new patients
Champaign Counseling LLC Clinical CurrentSince Aug 1, 2024 Accepting new patients
Dulski Counseling, LLC Clinical CurrentSince Jan 1, 2026 Accepting new patients
Insight Therapy PastSince Mar 11, 2013 Accepting new patients

Locations

1813 W Kirby Ave
Ste 120
Champaign, IL 61821
Phone (217) 383-1850

313 N Mattis Ave
Ste 116
Champaign, IL 61821
Phone (217) 203-2008

3362 Big Pine Trl
Ste A
Champaign, IL 61822
Phone (217) 383-0151

7 Dunlap Ct
Savoy, IL 61874
Phone (217) 203-2008

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194156422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 W KIRBY AVE STE 120",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618215410",
            "telephone_number": "217-383-1850",
            "fax_number": "217-383-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "BEN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.