Active NPI
Desiree R Avitia, LCSW
- Clinical Social Worker
- St Charles, IL
National Provider Identifier
1376229799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.024393
- Practice address
- 37W755 Il Route 38 Ste a
St Charles, IL 60175-7557 - Phone
- (630) 232-6840
- NPI assigned
- Jun 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.024393 | IL | Primary |
Addresses
Primary practice location
37W755 Il Route 38 Ste a
St Charles, IL 60175-7557
Mailing address
37W755 Il Route 38 Ste a
St Charles, IL 60175-7557
Phone (224) 523-5318
Other practice location 1
24014 W Renwick Rd
Ste 100-12 & 105-5
Plainfield, IL 60544
Phone (815) 200-1130
Other practice location 2
24014 W Renwick Rd
Suite 103
Plainfield, IL 60544
Phone (815) 200-1130
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149.024393 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mind Lodge | Clinical | Past | Accepting new patients |
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": "1687392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765152000000",
"number": "1376229799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37W755 IL ROUTE 38 STE A",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601757557",
"telephone_number": "224-523-5318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37W755 IL ROUTE 38 STE A",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601757557",
"telephone_number": "630-232-6840"
}
],
"practiceLocations": [
{
"address_1": "24014 W Renwick Rd",
"address_2": "Ste 100-12 & 105-5",
"address_purpose": "LOCATION",
"city": "Plainfield",
"state": "IL",
"postal_code": "60544",
"country_code": "US",
"telephone_number": "815-200-1130",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "24014 W Renwick Rd",
"address_2": "Suite 103",
"address_purpose": "LOCATION",
"city": "Plainfield",
"state": "IL",
"postal_code": "60544",
"country_code": "US",
"telephone_number": "815-200-1130",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AVITIA",
"first_name": "DESIREE",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-22",
"last_updated": "2025-12-08",
"certification_date": "2025-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.024393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.