Betty Ellen Lazar, LCSW, CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.01954 Issued in IL

Practice address

736 York CT
Northbrook, IL 60062-3955

Phone

(847) 208-9092

NPI assigned

Jan 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ellen Lazar Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1515888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515888000000",
    "number": "1669980462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 YORK CT",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600623955",
            "telephone_number": "847-208-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 YORK CT",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600623955",
            "telephone_number": "847-208-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "BETTY",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-14",
        "last_updated": "2018-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.01954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "LAZAR",
            "credential": "LCSW, CADC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Social Worker in Northbrook, IL
• Providers in Northbrook, 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 Jan 14, 2018; 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.