Individual provider Active NPI

Ashley Symmonds Bryer, LCSW, CADC

  • Clinical Social Worker
  • Dekalb, IL
National Provider Identifier
1275259152
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.028078 Issued in IL
Practice address
12 Health Services Dr
Dekalb, IL 60115-9637
Phone
(815) 756-4875
Fax
(815) 756-2944
NPI assigned
Oct 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 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 149.028078 IL Primary

Addresses

Primary practice location

12 Health Services Dr
Dekalb, IL 60115-9637

Mailing address

PO Box 1109
Dekalb, IL 60115-7109
Phone (815) 756-4875

Other identifiers 1

IdentifierTypeStateIssuer
474579189001MedicaidIL

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
I20250128000111 IL Practitioner - Clinical Social Worker 2264961820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

631 S 1St St
Dekalb, IL 60115-4117
Phone (815) 756-8501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.028078ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Nov 24, 2024 Accepting new patients
Dekalb Behavioral Health Foundation, Inc. Current Accepting new patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Nov 24, 2024 Accepting new patients

Locations

12 Health Services Dr
DeKalb, IL 60115
Phone (815) 756-4875

631 S 1st St
DeKalb, IL 60115
Phone (815) 756-4875

Organizations & group practices 3

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": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1275259152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1109",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601157109",
            "telephone_number": "815-756-4875",
            "fax_number": "815-756-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HEALTH SERVICES DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-756-4875",
            "fax_number": "815-756-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMMONDS BRYER",
        "first_name": "ASHLEY",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.028078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "474579189001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

Verify at the official NPI Registry.