Individual provider Active NPI

Rhonda Meacham, LCSW

  • Clinical Social Worker
  • Forest Park, IL
National Provider Identifier
1366766784
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.011604 Issued in IL
Practice address
7355 Madison St
Suite a
Forest Park, IL 60130-1561
Phone
(630) 347-2873
NPI assigned
Mar 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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 149.011604 IL Primary

Addresses

Primary practice location

7355 Madison St
Suite a
Forest Park, IL 60130-1561

Mailing address

7355 Madison St
Suite a
Forest Park, IL 60130-1561
Phone (630) 347-2873

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
149.011604ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1366766784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7355 MADISON ST",
            "address_2": "SUITE A",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301561",
            "telephone_number": "630-347-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 MADISON ST",
            "address_2": "SUITE A",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301561",
            "telephone_number": "630-347-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEACHAM",
        "first_name": "RHONDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.