Individual provider Active NPI

Laurie D. Roston, LCSW

  • Social Worker
  • Wilmette, IL
National Provider Identifier
1366450645
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
149-001171 Issued in IL
Practice address
3545 Lake Ave
Wilmette, IL 60091-1058
Phone
(847) 251-7350
Fax
(847) 853-2600
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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 149-001171 IL Primary

Addresses

Primary practice location

3545 Lake Ave
Wilmette, IL 60091-1058

Mailing address

9512 Lincolnwood Dr
Evanston, IL 60203-1116
Phone (847) 677-7661

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
I20070920000794 IL Practitioner - Clinical Social Worker 3375637333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Service Center of Wilmette Glenview Northbrook KenilworthGroup PAC ID 9739085549, 8 clinicians

Practice addresses (Care Compare)

191 Waukegan Rd
Suite 206
Northfield, IL 60093-2743
Phone (847) 251-7350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-001171ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Center of Wilmette Glenview Northbrook Kenilworth CurrentSince Sep 1, 2002 Accepting new patients

Locations

191 Waukegan Rd
Ste 206
Northfield, IL 60093
Phone (847) 251-7350

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1366450645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9512 LINCOLNWOOD DR",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602031116",
            "telephone_number": "847-677-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 LAKE AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911058",
            "telephone_number": "847-251-7350",
            "fax_number": "847-853-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTON",
        "first_name": "LAURIE",
        "middle_name": "D.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149-001171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.