Individual provider Active NPI

Stephanie Erin Budrow, LCSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1871768481
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013388 Issued in IL
Practice address
3380 Lacrosse LN # 116
Naperville, IL 60564-8520
Phone
(847) 772-2765
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.010028 IL
Clinical Social Worker 1041C0700X 149.013388 IL Primary

Addresses

Primary practice location

3380 Lacrosse LN # 116
Naperville, IL 60564-8520

Mailing address

2665 Haddassah Dr
Naperville, IL 60565-3067
Phone (847) 772-2765

Other practice location 1

2665 Haddassah Dr
Naperville, IL 60565-3067
Phone (847) 772-2765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 27, 2016 through Jan 27, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
150.010028ILMDSocial Worker
149.013388ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Simple Wellness Counseling LLC Clinical CurrentSince May 7, 2023 Accepting new patients

Locations

3380 Lacrosse Ln
#116
Naperville, IL 60564
Phone (847) 772-2765

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1871768481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 HADDASSAH DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605653067",
            "telephone_number": "847-772-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 LACROSSE LN # 116",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648520",
            "telephone_number": "847-772-2765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2665 Haddassah Dr",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605653067",
            "country_code": "US",
            "telephone_number": "847-772-2765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUDROW",
        "first_name": "STEPHANIE",
        "middle_name": "ERIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.010028",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.