Individual provider Active NPI

Adrian Marie Byrd, LCSW

  • Clinical Social Worker
  • Decatur, IL
National Provider Identifier
1194992503
Registry record updated Apr 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012906 Issued in IL
Practice address
5130 Hickory Point Frontage Rd Ste 219
Decatur, IL 62526-9773
Phone
(217) 358-4548
Fax
(217) 706-5779
NPI assigned
May 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2024

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 149012906 IL Primary

Addresses

Primary practice location

5130 Hickory Point Frontage Rd Ste 219
Decatur, IL 62526-9773

Mailing address

5130 Hickory Point Frontage Rd Ste 219
Decatur, IL 62526-9773
Phone (217) 358-4548

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
I20080805000080 IL Practitioner - Clinical Social Worker 1557435823 Reassigns benefits to 2 organizations
Practice locations: Decatur, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Rooted Integrative Therapy Services, PLLC Clinical Current Accepting new patients
Brightside Medical, P.a. CurrentSince Mar 1, 2026 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients
Home Psych Services, P.C. Past Accepting new patients
Jackson Therapy Clinical Past Accepting new patients

Locations

332 S Michigan Ave
Chicago, IL 60604
Phone (773) 633-7479

Organizations & group practices 5

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": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713571200000",
    "number": "1194992503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 HICKORY POINT FRONTAGE RD STE 219",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269773",
            "telephone_number": "217-358-4548",
            "fax_number": "217-706-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 HICKORY POINT FRONTAGE RD STE 219",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269773",
            "telephone_number": "217-358-4548",
            "fax_number": "217-706-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "ADRIAN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2024-04-20",
        "certification_date": "2024-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.