Individual provider Active NPI

Debra C Farnsworth, MSW, LCSW

  • Clinical Social Worker
  • Sycamore, IL
National Provider Identifier
1336733724
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149024733 Issued in IL
Practice address
760 Foxpointe Dr
Sycamore, IL 60178-3290
Phone
(815) 748-8334
NPI assigned
Feb 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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 149024733 IL Primary

Addresses

Primary practice location

760 Foxpointe Dr
Sycamore, IL 60178-3290

Mailing address

PO Box 1109
Dekalb, IL 60115-7109

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
I20220928003651 IL Practitioner - Clinical Social Worker 2961888995 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149024733ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Aug 4, 2022 Accepting new patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Aug 4, 2022 Accepting new patients
Dekalb Behavioral Health Foundation, Inc. Current Accepting new patients
Kishwaukee Community Health Services Center PastSince Aug 13, 2023 Accepting new patients

Locations

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

Organizations & group practices 4

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": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1336733724",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 FOXPOINTE DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783290",
            "telephone_number": "815-748-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNSWORTH",
        "first_name": "DEBRA",
        "middle_name": "C",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149024733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.