Active NPI
Stephanie L Davingman, CADC, LCSW, LMFT
- Clinical Social Worker
- Bloomington, IL
National Provider Identifier
1316208192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149-0007470
- Practice address
- 1102 W Hamilton Rd
Bloomington, IL 61704-8657 - Phone
- (309) 834-3231
- NPI assigned
- Jun 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149-0007470 | IL | Primary |
| Marriage & Family Therapist | 106H00000X | 166-000510 | IL |
Addresses
Primary practice location
1102 W Hamilton Rd
Bloomington, IL 61704-8657
Mailing address
1102 W. Hamilton Rd.
Lutheran Child and Family Services
Bloomington, IL 61704-8657
Phone (309) 834-3231
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 |
|---|---|---|---|
| 149-0007470 | IL | MD | Clinical Social Worker |
| 166-000510 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339027200000",
"number": "1316208192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1102 W. HAMILTON RD.",
"address_2": "LUTHERAN CHILD AND FAMILY SERVICES",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617048657",
"telephone_number": "309-834-3231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 W HAMILTON RD",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617048657",
"telephone_number": "309-834-3231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVINGMAN",
"first_name": "STEPHANIE",
"middle_name": "L",
"credential": "CADC, LCSW, LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-07",
"last_updated": "2012-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149-0007470",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166-000510",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.