Sophia Corrine Soleil Dawson, LSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.020911 Issued in IL

Practice address

3400 W New Leaf LN
Peoria, IL 61615-3311

Phone

(309) 589-1011

NPI assigned

May 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Sophia Corrine Soleil Lee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Human Service Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Peoria, IL
  • NPI 1144549494
  NPD (past)

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1366000911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 N ROCHELLE LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616041035",
            "telephone_number": "309-282-1087",
            "fax_number": "309-282-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W NEW LEAF LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616153311",
            "telephone_number": "309-589-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "SOPHIA",
        "middle_name": "CORRINE SOLEIL",
        "name_prefix": "Mrs.",
        "credential": "LSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOPHIA",
            "last_name": "LEE",
            "middle_name": "CORRINE SOLEIL",
            "prefix": "MS.",
            "credential": "LSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachael M Davis, M.D.
• Ronald Edwin Davis, M.D.
• Ryan James Davis, DMD, MS
• Antoine Dawalibi, DO
• Erick Dru Dawalt, PHARM D
• Jacob Day
• Meghan Eileen Day, OTR/L
• Tessa Marie Day, LCSW
• Dorsa Dayani, MD
• Pedro A De Alarcon, MD

• Clinical Social Worker in Peoria, IL
• Providers in Peoria, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.