Individual provider Active NPI

Raya Newman

  • Clinical Social Worker
  • Dekalb, IL
National Provider Identifier
1659755965
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149017667 Issued in IL
Practice address
631 S 1St St
Dekalb, IL 60115-4117
Phone
(815) 756-8501
Fax
(815) 756-5849
NPI assigned
Jul 16, 2015
Last updated
Jul 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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 149017667 IL Primary

Addresses

Primary practice location

631 S 1St St
Dekalb, IL 60115-4117

Mailing address

12 Health Services Dr
Dekalb, IL 60115-9637
Phone (815) 756-4875

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
I20150713000606 IL Practitioner - Clinical Social Worker 7012229586 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Services in Health Psychology, LTDGroup PAC ID 4981736550, 19 clinicians

Practice addresses (Care Compare)

1625 Bethany Rd
Sycamore, IL 60178-3124
Phone (779) 777-7335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149017667ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Behavioral Health Foundation, Inc. Current Accepting new patients
Professional Services in Health Psychology, LTD Clinical CurrentSince May 13, 2023 Accepting new patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Jan 23, 2019 Accepting new patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Jan 23, 2019 Accepting new patients
Three Birds Mental Health Services PLLC Past Accepting new patients

Locations

12 Health Services Dr
DeKalb, IL 60115
Phone (815) 756-4875

631 S 1st St
DeKalb, IL 60115
Phone (815) 756-4875

1625 Bethany Rd
Sycamore, IL 60178
Phone (779) 777-7335

1625 Bethany Rd
Ste 1
Sycamore, IL 60178
Phone (779) 777-7335

2540 Hauser Ross Dr
Ste 225
Sycamore, IL 60178
Phone (815) 758-8400

Organizations & group practices 5

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": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1659755965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HEALTH SERVICES DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-756-4875",
            "fax_number": "815-756-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S 1ST ST",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601154117",
            "telephone_number": "815-756-8501",
            "fax_number": "815-756-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "RAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

Verify at the official NPI Registry.