Individual provider Active NPI

Brianna Sorensen, LCSW, PC

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1073950564
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149016717 Issued in IL
Practice address
4247 N Damen Ave # 1
Chicago, IL 60618-3011
Phone
(630) 740-3180
NPI assigned
May 24, 2013
Last updated
Dec 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150013963 IL
Clinical Social Worker 1041C0700X 149016717 IL Primary

Addresses

Primary practice location

4247 N Damen Ave # 1
Chicago, IL 60618-3011

Mailing address

4247 N Damen Ave # 1
Chicago, IL 60618-3011
Phone (630) 740-3180

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
I20170427000149 IL Practitioner - Clinical Social Worker 7719264993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Brianna Sorensen LCSW PCGroup PAC ID 5092092270, 5 clinicians

Practice addresses (Care Compare)

4247 N Damen Ave
Suite 1
Chicago, IL 60618-3011
Phone (630) 740-3180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150013963ILMDSocial Worker
149016717ILMDClinical Social Worker

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": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1073950564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4247 N DAMEN AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183011",
            "telephone_number": "630-740-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4247 N DAMEN AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183011",
            "telephone_number": "630-740-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "BRIANNA",
        "credential": "LCSW, PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-24",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150013963",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.