Individual provider Active NPI

Allison Mozdzen, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1003453895
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019705 Issued in IL
Practice address
1841 W Melrose St Apt 2
Chicago, IL 60657-8213
Phone
(847) 239-0014
NPI assigned
Nov 29, 2019
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.019705 IL Primary

Addresses

Primary practice location

1841 W Melrose St Apt 2
Chicago, IL 60657-8213

Mailing address

1841 W Melrose St Apt 2
Chicago, IL 60657-8213
Phone (847) 239-0014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240501002769 IL Practitioner - Clinical Social Worker 1254771777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifepath Therapy Associates, LLCGroup PAC ID 7911333703, 12 clinicians

Practice addresses (Care Compare)

25 E Washington St
Suite 1835
Chicago, IL 60602-1836
Phone (312) 940-3655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.019705ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifepath Therapy Associates, LLC Clinical CurrentSince Mar 20, 2024 Accepting new patients

Locations

25 E Washington St
Ste 1835
Chicago, IL 60602
Phone (312) 940-3655

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1574985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1003453895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 W MELROSE ST APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606578213",
            "telephone_number": "847-239-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 W MELROSE ST APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606578213",
            "telephone_number": "847-239-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZDZEN",
        "first_name": "ALLISON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-29",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.