Individual provider Active NPI

Lynn M King Panepinto, LCSW

  • Clinical Social Worker
  • Orland Park, IL
National Provider Identifier
1235865718
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.023963 Issued in IL
Practice address
18301 Distinctive Dr
Orland Park, IL 60467-9461
Phone
(708) 928-5700
Fax
(708) 570-1617
NPI assigned
Jul 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 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 149.023963 IL Primary

Addresses

Primary practice location

18301 Distinctive Dr
Orland Park, IL 60467-9461

Mailing address

18301 Distinctive Dr
Orland Park, IL 60467-9461

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
I20221116000044 IL Practitioner - Clinical Social Worker 3375911779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18301 Distinctive Dr
Orland Park, IL 60467-9461
Phone (708) 928-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.023963ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Behavioral Healthcare LTD. CurrentSince Aug 5, 2022 Accepting new patients

Locations

18301 Distinctive Dr
Orland Park, IL 60467
Phone (708) 606-1334

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": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1235865718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18301 DISTINCTIVE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 DISTINCTIVE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679461",
            "telephone_number": "708-928-5700",
            "fax_number": "708-570-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING PANEPINTO",
        "first_name": "LYNN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.023963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.