Individual provider Active NPI

Julia Wenzlaff, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1053855098
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.011950 Issued in IL
Practice address
1747 W Roosevelt Rd
155 Ijr
Chicago, IL 60608-1264
Phone
(312) 996-8083
NPI assigned
Dec 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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 149.011950 IL Primary

Addresses

Primary practice location

1747 W Roosevelt Rd
155 Ijr
Chicago, IL 60608-1264

Mailing address

3963 W Belmont Ave
Unit 132
Chicago, IL 60618-5149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.011950ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
TMS Psychological Services PC PastSince Sep 1, 2017 Accepting new patients

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": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1053855098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3963 W BELMONT AVE",
            "address_2": "UNIT 132",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 W ROOSEVELT RD",
            "address_2": "155 IJR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081264",
            "telephone_number": "312-996-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZLAFF",
        "first_name": "JULIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.