Cornwall Counseling Clinic PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CORNWALL COUNSELING CLINIC PLLC

Practice address

977 Lakeview Pkwy Ste 110
Vernon Hills, IL 60061-1444

Phone

(847) 915-2025

Fax

(847) 915-2025

NPI assigned

Nov 3, 2025

Organization subpart

No

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

Authorized official

Name

Richard Ward Cornwall, LCSW, MSWNPI 1194218909

Title

Licensed Clinical Social Worker

Phone

(847) 915-2025

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard Ward Cornwall, LCSW

  • Clinical Social Worker
  • Barrington, IL
  • NPI 1194218909
  NPD Authorized official

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1629947114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 LAKEVIEW PKWY STE 110",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611444",
            "telephone_number": "847-915-2025",
            "fax_number": "847-915-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 LAKEVIEW PKWY STE 110",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611444",
            "telephone_number": "847-915-2025",
            "fax_number": "847-915-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNWALL COUNSELING CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "CORNWALL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "WARD",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "847-915-2025",
        "authorized_official_credential": "LCSW, MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Vernon Hills, IL
• Providers in Vernon Hills, 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 Nov 3, 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.

Verify at the official NPI Registry.