Active NPI
Lesley Glenn
- Clinical Social Worker
- Lombard, IL
National Provider Identifier
1639809494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149024504
- Practice address
- 422 S Main St Unit 2059
Lombard, IL 60148-2600 - Phone
- (224) 558-3261
- NPI assigned
- Jun 14, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149024504 | IL | Primary |
Addresses
Primary practice location
422 S Main St Unit 2059
Lombard, IL 60148-2600
Mailing address
422 S Main St Unit 2059
Lombard, IL 60148-2600
Phone (224) 558-3261
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149024504 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Soul Therapy LLC | Clinical | Current | Accepting new patients |
Locations
422 S Main St
Lombard, IL 60148
Phone (224) 558-3261
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.
-
- Clinical Social Worker
- Elk Grove Village, IL
- NPI 1184458598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724803200000",
"number": "1639809494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "422 S MAIN ST UNIT 2059",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601482600",
"telephone_number": "224-558-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "422 S MAIN ST UNIT 2059",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601482600",
"telephone_number": "224-558-3261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "LESLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-14",
"last_updated": "2024-08-28",
"certification_date": "2024-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149024504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.