Active NPI
Nicole Bennett, LCSW
- Clinical Social Worker
- Belvidere, IL
National Provider Identifier
1194549402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149020453
- Practice address
- 8787 Beloit Rd
Belvidere, IL 61008-1701 - Phone
- (815) 544-0190
- NPI assigned
- Nov 13, 2024
- 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 | 149020453 | IL | Primary |
Addresses
Primary practice location
8787 Beloit Rd
Belvidere, IL 61008-1701
Mailing address
3606 Pinecrest Rd
Rockford, IL 61107-1308
Phone (815) 979-7252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149020453 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731456000000",
"number": "1194549402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3606 PINECREST RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611071308",
"telephone_number": "815-979-7252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8787 BELOIT RD",
"city": "BELVIDERE",
"state": "IL",
"postal_code": "610081701",
"telephone_number": "815-544-0190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "NICOLE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-13",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149020453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belvidere, IL
- Belvidere Emergency Physicians, LLC
- Belvidere Family Chiropractic
- Belvidere Nursing Center
- Belvidere Physical Therapy Inc
- Belvidere Rehab & Sports Medicine
- Whitney Anne Bennett, PHARMD
- Lora Ethelyn Bertell, PHARMD
- Alfredo Daniel Bizzocchi
- Jeremiah Blaser, PT, DPT
- Board of Trustees of the University of Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.