Active NPI
Nora Purcell, LCSW
- Clinical Social Worker
- Crystal Lake, IL
National Provider Identifier
1689795023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.011153
- Practice address
- 1575 Glacier Cir
Crystal Lake, IL 60014-8903 - Phone
- (847) 636-7419
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 149.011153 | IL | Primary |
Addresses
Primary practice location
1575 Glacier Cir
Crystal Lake, IL 60014-8903
Mailing address
1575 Glacier Cir
Crystal Lake, IL 60014-8903
Phone (847) 636-7419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6003359 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149.011153 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452902400000",
"number": "1689795023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 GLACIER CIR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600148903",
"telephone_number": "847-636-7419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 GLACIER CIR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600148903",
"telephone_number": "847-636-7419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURCELL",
"first_name": "NORA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2016-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.011153",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6003359",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.