Individual provider Active NPI

Lindsey Kovalik Bianchini, LCSW, LISW-CP

  • Clinical Social Worker
  • St Charles, IL
National Provider Identifier
1477022648
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.022936 Issued in IL
Practice address
103 N 11TH Ave Ste 106
St Charles, IL 60174-2278
Phone
(630) 296-4169
NPI assigned
Nov 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.022936 IL Primary
Clinical Social Worker 1041C0700X 14679 SC
Clinical Social Worker 1041C0700X C015433 NC

Addresses

Primary practice location

103 N 11TH Ave Ste 106
St Charles, IL 60174-2278

Mailing address

103 N 11TH Ave Ste 106
St Charles, IL 60174-2278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 2, 2023 through Nov 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.022936ILMDClinical Social Worker
C015433NCMDClinical Social Worker
14679SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Obsidian Behavioral Health PLLC Social Worker CurrentSince May 1, 2021 Accepting new patients

Locations

103 N 11th Ave
Ste 106
St Charles, IL 60174
Phone (630) 296-4169

103 N 11th Ave
Ste 105
St Charles, IL 60174
Phone (732) 407-6130

902 S Randall Rd
Ste C134
St Charles, IL 60174

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": "1542412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1477022648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N 11TH AVE STE 106",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N 11TH AVE STE 106",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742278",
            "telephone_number": "630-296-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALIK BIANCHINI",
        "first_name": "LINDSEY",
        "credential": "LCSW, LISW-CP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-17",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022936",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "14679",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015433",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.