Individual provider Active NPI

Barry Lee

  • Clinical Social Worker
  • Watseka, IL
National Provider Identifier
1497111942
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
323 W Mulberry St
Watseka, IL 60970-1568
Phone
(815) 432-5241
NPI assigned
Jan 13, 2016
Last updated
Sep 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.010087 IL
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

323 W Mulberry St
Watseka, IL 60970-1568

Mailing address

323 W Mulberry St
PO Box 322
Watseka, IL 60970-1568

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
I20160211002316 IL Practitioner - Clinical Social Worker 5193029189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iroquois Mental Health CenterGroup PAC ID 4082673025, 5 clinicians

Practice addresses (Care Compare)

323 W Mulberry St
Watseka, IL 60970-1568
Phone 8154325241201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.010087ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Iroquois Mental Health Center CurrentSince Jan 16, 2016 Accepting new patients

Locations

323 W Mulberry St
Watseka, IL 60970
Phone 8154325241245

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1497111942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W MULBERRY ST",
            "address_2": "PO BOX 322",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 W MULBERRY ST",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701568",
            "telephone_number": "815-432-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BARRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-13",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010087",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

Verify at the official NPI Registry.