Individual provider Active NPI

Juanita Melenne Mosquera, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1003927229
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012091 Issued in IL
Practice address
5901 N Sheridan Rd Apt 9C
Chicago, IL 60660-3635
Phone
(773) 440-3008
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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 149.012091 IL Primary

Addresses

Primary practice location

5901 N Sheridan Rd Apt 9C
Chicago, IL 60660-3635

Mailing address

5901 N Sheridan Rd Apt 9C
Chicago, IL 60660-3635
Phone (773) 440-3008

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012091ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1003927229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 N SHERIDAN RD APT 9C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603635",
            "telephone_number": "773-440-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 N SHERIDAN RD APT 9C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603635",
            "telephone_number": "773-440-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSQUERA",
        "first_name": "JUANITA",
        "middle_name": "MELENNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012091",
            "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 Feb 16, 2011; 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.