Individual provider Active NPI

Deborah A Hedin, LCSW

  • Clinical Social Worker
  • Champaign, IL
National Provider Identifier
1639224835
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
701 Devonshire Dr
Suite C212
Champaign, IL 61820-7337
Phone
(217) 356-2213
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

701 Devonshire Dr
Suite C212
Champaign, IL 61820-7337

Mailing address

1720 Coronado Dr
Champaign, IL 61820-7020
Phone (217) 356-2213

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.005527ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639224835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 CORONADO DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207020",
            "telephone_number": "217-356-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR",
            "address_2": "SUITE C212",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207337",
            "telephone_number": "217-356-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDIN",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.