Individual provider Active NPI

Deanna Carol Watson, LCSW

  • Clinical Social Worker
  • Channahon, IL
National Provider Identifier
1255614236
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149007330 Issued in IL
Practice address
23157 S Thomas Dillon Dr
Channahon, IL 60410-3132
Phone
(815) 467-8181
NPI assigned
Sep 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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 149007330 IL Primary

Addresses

Primary practice location

23157 S Thomas Dillon Dr
Channahon, IL 60410-3132

Mailing address

23157 S Thomas Dillon Dr
Channahon, IL 60410-3132
Phone (815) 467-8181

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
I20190220002216 IL Practitioner - Clinical Social Worker 5496093221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Counseling and Coaching of Illinois LLCGroup PAC ID 5496093213, 19 clinicians

Practice addresses (Care Compare)

25224 W Eames St
Suite D
Channahon, IL 60410-5256
Phone (815) 467-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149007330ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Counseling & Coaching of Illinois, LLC CurrentSince Dec 25, 2018 Accepting new patients
Alliance Counseling & Coaching Past Accepting new patients

Locations

25224 W Eames St
Channahon, IL 60410
Phone (815) 467-8181

25224 W Eames St
Ste D
Channahon, IL 60410
Phone (815) 467-8181

1425 Essington Rd
Joliet, IL 60435
Phone (773) 510-5122

326 Alana Dr
New Lenox, IL 60451
Phone (815) 467-8181

Organizations & group practices 2

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": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1255614236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23157 S THOMAS DILLON DR",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604103132",
            "telephone_number": "815-467-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23157 S THOMAS DILLON DR",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604103132",
            "telephone_number": "815-467-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DEANNA",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149007330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Channahon, IL

Sources for this page

Verify at the official NPI Registry.