Roxanne Rae Willis, PHD, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

150104741 Issued in IL

Practice address

213 S Prairie St
Batavia, IL 60510-2769

Phone

(630) 947-6828

NPI assigned

Dec 10, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1235735515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S PRAIRIE ST",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605102769",
            "telephone_number": "630-947-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S PRAIRIE ST",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605102769",
            "telephone_number": "630-947-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ROXANNE",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "PHD, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150104741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "colleen@healthandhealingtherapy.com",
            "affiliation": "N",
            "address_1": "213 S Prairie St",
            "city": "Batavia",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605102769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Kathleen M Wilk, MS SLP
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• Jennifer Williamee, LCSW
• Claudette Williams
• Erica Christine Wilson
• George Wilson
• Catherine D Winters, MS, CCC-SLP
• Mari Jo Wittum, MCP LCPC
• Woodfield Ortho Services LLC (Woodfield Orthotics & Prosthetics)

• Clinical Social Worker in Batavia, IL
• Providers in Batavia, 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 Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.