Denise Gulotta, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.016834 Issued in IL

Practice address

2656 W Montrose Ave Ste 104
Chicago, IL 60618-1557

Phone

(773) 969-6030

Fax

(313) 680-0660

NPI assigned

Aug 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 2, 2024 through Jan 2, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Innerbloom Therapy Practice PC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1457080301
  NPD Authorized official

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

{
    "created_epoch": "1501891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1053836585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 N CLYBOURN AVE STE A222",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102451",
            "telephone_number": "773-969-6030",
            "fax_number": "312-680-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2656 W MONTROSE AVE STE 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181557",
            "telephone_number": "773-969-6030",
            "fax_number": "313-680-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULOTTA",
        "first_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-05",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin James Gulizia, MD
• Ashley Gullatt, RN
• Thomas Gullberg
• Paulette Y. Gulley, MS CCC SLP
• Jhoanna Gulmatico, APN
• Ranier Guloy
• Kate Gulyayev, LMFT
• Nader E Guma, MD, MPH
• Rae Leonor Ferrer Gumayan, MD
• Rhonda E. Gumbel-Thomas

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.