Individual provider Active NPI

Michael Reeves, LCSW, CADC

  • Clinical Social Worker
  • Springfield, IL
National Provider Identifier
1780126169
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018838 Issued in IL
Practice address
435 W Washington St
Springfield, IL 62702-5006
Phone
(217) 210-2476
NPI assigned
Nov 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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 149018838 IL Primary

Addresses

Primary practice location

435 W Washington St
Springfield, IL 62702-5006

Mailing address

435 W Washington St
Springfield, IL 62702-5006
Phone (217) 210-2476

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

NPI Registry JSON

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1780126169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 W WASHINGTON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025006",
            "telephone_number": "217-210-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 W WASHINGTON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025006",
            "telephone_number": "217-210-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

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

Verify at the official NPI Registry.