Individual provider Active NPI

David Ensor

  • Social Worker
  • Crystal Lake, IL
National Provider Identifier
1346052834
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.115345 Issued in IL
Practice address
27 Grant St
Crystal Lake, IL 60014-4372
Phone
(815) 276-3947
NPI assigned
Jan 22, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.115345 IL Primary

Addresses

Primary practice location

27 Grant St
Crystal Lake, IL 60014-4372

Mailing address

160 Bright Oaks Cir
Cary, IL 60013-1522

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
150.115345ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blair Counseling and Mediation PC CurrentSince Jan 26, 2025 Accepting new patients

Locations

27 Grant St
Crystal Lake, IL 60014
Phone (815) 276-3947

12555 Farm Hill Dr
Ste 500
Huntley, IL 60142
Phone (901) 205-9395

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1346052834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BRIGHT OAKS CIR",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600131522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 GRANT ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144372",
            "telephone_number": "815-276-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENSOR",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.115345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.