Renewal Comprehensive Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149011528 Issued in IL

Legal business name

RENEWAL COMPREHENSIVE SERVICES, LLC

Practice address

5950 E Lincoln Ave Ste 300
Lisle, IL 60532-3387

Phone

(312) 399-3077

NPI assigned

Apr 19, 2012

Last updated

Oct 2, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leslie Lewis Ford, PH.D., LCSWNPI 1619250180

Title

Practice Owner

Phone

(312) 399-3077

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leslie Lewis Ford, PH.D. LCSW

  • Clinical Social Worker
  • Lisle, IL
  • NPI 1619250180
  Authorized official Same address or phone

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569974400000",
    "number": "1982961603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 W BOUGHTON RD # 166",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401508",
            "telephone_number": "312-399-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 E LINCOLN AVE STE 300",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323387",
            "telephone_number": "312-399-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWAL COMPREHENSIVE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2019-10-02",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "312-399-3077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Lisle, IL
• Providers in Lisle, 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 Oct 2, 2019; 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.