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PROVENA ST MARYS HOSPITAL
NPI 1194982025
Social Worker - Clinical in Bourbonnais, IL

Active since May 19, 2008
21 HERITAGE DRIVE, SUITE 102, BOURBONNAIS, IL 60914(815) 937-2081(815) 937-8798 Get Directions Write a Review

NPPES record last updated: May 19, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Provena St Marys Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVENA ST MARYS HOSPITAL (NPI 1194982025) is a healthcare organization registered as a clinical in Bourbonnais, Illinois and active in the NPI registry since May 2008. The organization lists Barry S Lee, Eap Substance Abuse Counselor, as its authorized official.

NPPES Registry Identity

NPI1194982025
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NamePROVENA ST MARYS HOSPITAL
Location Address21 HERITAGE DRIVE, SUITE 102Bourbonnais, IL 60914
Mailing Address21 Heritage Drive, Suite 102Bourbonnais, IL 60914 · (815) 937-2081 · Fax (815) 937-8798
Phone(815) 937-2081
Fax(815) 937-8798
Organization SubpartNo
Authorized OfficialBarry S LeeEap Substance Abuse Counselor · (815) 937-2081
Enumeration DateMay 19, 2008
✔ NPI 1194982025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149006455
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
21 HERITAGE DRIVE, Bourbonnais, IL 60914
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MING XU MD
Psychiatry & Neurology (Psychiatry)
21 HERITAGE DRIVE, SUITE 102
BOURBONNAIS, IL 60914
Kankakee County (815) 937-8204
MICHELLE MEYERS MOTR/L
Occupational Therapist
21 HERITAGE DRIVE
BOURBONNAIS, IL 60914
Kankakee County (815) 937-8220
MAIKE MEYER
Physical Therapist
21 HERITAGE DRIVE, SUITE 101
BOURBONNAIS, IL 60914
Kankakee County (815) 937-8220

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provena St Marys Hospital's NPI number?

The NPI number for Provena St Marys Hospital is 1194982025. It was assigned to this organization in the NPPES registry on May 19, 2008.

Where is Provena St Marys Hospital located?

Provena St Marys Hospital is located at 21 Heritage Drive Suite 102, Bourbonnais, IL 60914. The listed phone number is (815) 937-2081.

What is Provena St Marys Hospital's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Provena St Marys Hospital was last updated on May 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.