Kevin M Stanford, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018552 Issued in IL

Practice address

25 Telser Rd Unit 743
Lake Zurich, IL 60047-3633

Phone

(773) 644-1522

NPI assigned

Oct 1, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1508190042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 TELSER RD UNIT 743",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600473633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 TELSER RD UNIT 743",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600473633",
            "telephone_number": "773-644-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Lake Zurich, IL
• Providers in Lake Zurich, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.