Individual provider Active NPI

Kristy Lynn Garry, LCSW

  • Clinical Social Worker
  • Orland Park, IL
National Provider Identifier
1740552256
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015092 Issued in IL
Practice address
9631 W 153Rd St Ste 37
Orland Park, IL 60462-3778
Phone
(708) 837-8519
NPI assigned
Jan 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

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 149015092 IL Primary

Addresses

Primary practice location

9631 W 153Rd St Ste 37
Orland Park, IL 60462-3778

Mailing address

11130 S 84TH Ave Apt 1B
Palos Hills, IL 60465-2419
Phone (708) 837-8519

Other names 1

  • Kristy Lynn Levenda Other name

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

LicenseStateTypeSpecialty
149015092ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1740552256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 S 84TH AVE APT 1B",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604652419",
            "telephone_number": "708-837-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9631 W 153RD ST STE 37",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623778",
            "telephone_number": "708-837-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRY",
        "first_name": "KRISTY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "LEVENDA",
            "middle_name": "LYNN",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.