Active NPI
Blanca E Sepulveda, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1003452541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.021351
- Practice address
- 50 E Washington St Ste 301
Chicago, IL 60602-2142 - Phone
- (312) 252-9500
- NPI assigned
- Nov 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.021351 | IL | Primary |
Addresses
Primary practice location
50 E Washington St Ste 301
Chicago, IL 60602-2142
Mailing address
2226 W 18TH PL Apt 1B
Chicago, IL 60608-2531
Phone (773) 895-3128
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.021351 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St James Cathedral Counseling Center | Clinical | Current | Accepting new patients |
Locations
50 E Washington St
Ste 301
Chicago, IL 60602
Phone (312) 252-9500
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": "1574121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574121600000",
"number": "1003452541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2226 W 18TH PL APT 1B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606082531",
"telephone_number": "773-895-3128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 E WASHINGTON ST STE 301",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606022142",
"telephone_number": "312-252-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEPULVEDA",
"first_name": "BLANCA",
"middle_name": "E",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-19",
"last_updated": "2019-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.021351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.