Rachon A Stovall, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149023424 Issued in IL

Practice address

22430 Arquilla Dr
Richton Park, IL 60471-1537

Phone

(773) 621-3093

NPI assigned

Sep 20, 2021

Last updated

Sep 20, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1851061873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22430 ARQUILLA DR",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711537",
            "telephone_number": "773-621-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22430 ARQUILLA DR",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711537",
            "telephone_number": "773-621-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "RACHON",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://lifealignedcounseling.com/",
            "affiliation": "Y",
            "affiliationName": "Life Aligned Counseling and Consulting",
            "address_1": "1136 S Delano Ct W Ste B201",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606053734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Richton Park, IL
• Providers in Richton Park, 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 Sep 20, 2021; 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.