Individual provider Active NPI

Brenna L Panares, MSW LCSW

  • Clinical Social Worker
  • Frankfort, IL
National Provider Identifier
1669585626
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-007831 Issued in IL
Practice address
20500 S la Grange Rd
Suite 200 S
Frankfort, IL 60423-1356
Phone
(815) 806-9300
Fax
(815) 806-3076
NPI assigned
Aug 16, 2006
Last updated
Mar 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Clinical Social Worker 1041C0700X 149-007831 IL Primary

Addresses

Primary practice location

20500 S la Grange Rd
Suite 200 S
Frankfort, IL 60423-1356

Mailing address

20500 S la Grange Rd
Suite 200 S
Frankfort, IL 60423-1356
Phone (815) 806-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 17, 2023 through Mar 17, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149-007831ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Solutions Counseling Past Accepting new patients
Personal Solutions Counseling, PC Clinical Past Accepting new patients

Organizations & group practices 2

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1669585626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20500 S LA GRANGE RD",
            "address_2": "SUITE 200 S",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231356",
            "telephone_number": "815-806-9300",
            "fax_number": "815-806-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20500 S LA GRANGE RD",
            "address_2": "SUITE 200 S",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231356",
            "telephone_number": "815-806-9300",
            "fax_number": "815-806-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANARES",
        "first_name": "BRENNA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-007831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

Verify at the official NPI Registry.