Individual provider Active NPI

Savannah A Regis, LCSW

  • Clinical Social Worker
  • Joliet, IL
National Provider Identifier
1336968080
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.026453 Issued in IL
Practice address
300 Republic Ave
Joliet, IL 60435-6520
Phone
(815) 725-1440
Fax
(815) 725-1550
NPI assigned
Oct 9, 2024
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 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 149.026453 IL Primary

Addresses

Primary practice location

300 Republic Ave
Joliet, IL 60435-6520

Mailing address

2209 N Bogdan LN Apt B
Joliet, IL 60432-3193
Phone (815) 483-8219

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

LicenseStateTypeSpecialty
149.026453ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nasr LTD Clinical CurrentSince Oct 13, 2024 Accepting new patients

Locations

300 Republic Ave
Joliet, IL 60435
Phone (815) 725-1440

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": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1336968080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 N BOGDAN LN APT B",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604323193",
            "telephone_number": "815-483-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 REPUBLIC AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356520",
            "telephone_number": "815-725-1440",
            "fax_number": "815-725-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGIS",
        "first_name": "SAVANNAH",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.