Active NPI
Elizabeth Reynolds
- Clinical Social Worker
- Lombard, IL
National Provider Identifier
1245623073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.011908
- Practice address
- 413 S 3Rd St
Lombard, IL 60148-3103 - Phone
- (630) 981-7718
- NPI assigned
- Mar 18, 2015
- Last updated
- Dec 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 149011980 | IL | |
| Mental Health Counselor | 101YM0800X | 149.011908 | IL | |
| Clinical Social Worker | 1041C0700X | 149011908 | IL | |
| Clinical Social Worker | 1041C0700X | 149.011908 | IL | Primary |
Addresses
Primary practice location
413 S 3Rd St
Lombard, IL 60148-3103
Mailing address
444 E Roosevelt Rd # 131
Lombard, IL 60148-4630
Phone (630) 981-7718
Other names 1
- Liz Reynolds
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 |
|---|---|---|---|
| 149011980 | IL | MD | Mental Health Counselor |
| 149.011908 | IL | MD | Clinical Social Worker |
| 149011908 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Liz Reynolds LCSW LTD | Clinical | Current | Accepting new patients |
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, 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": "1426636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1245623073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "444 E ROOSEVELT RD # 131",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601484630",
"telephone_number": "630-981-7718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 S 3RD ST",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601483103",
"telephone_number": "630-981-7718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-18",
"last_updated": "2021-12-30",
"certification_date": "2021-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "149011980",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "149.011908",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149011908",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.011908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LIZ",
"last_name": "REYNOLDS",
"credential": "LCSW",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.