David Petersmark, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149027570 Issued in IL

Practice address

1315 N Highland Ave Ste 202
Aurora, IL 60506-1460

Phone

(630) 394-1379

Fax

(331) 239-2705

NPI assigned

Jun 22, 2022

Last updated

Feb 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

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

• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Clinical

  Medicare reassignment Care Compare group NPD
• Chicagoland Counseling PLLC

  dba Ellie Mental Health

  • Clinical Social Worker
  • Aurora, IL
  • NPI 1265215925
  Medicare reassignment NPD
• Willis Healthcare Inc

  • In Home Supportive Care Agency
  • Chicago, IL
  • NPI 1063157527
  NPD
• Psychology Specialists LTD

  dba LifeStance Health

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1093446866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 752123",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772752123",
            "telephone_number": "312-476-9064",
            "fax_number": "312-900-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 N HIGHLAND AVE STE 202",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061460",
            "telephone_number": "630-394-1379",
            "fax_number": "331-239-2705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1448 N Milwaukee Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606226412",
            "country_code": "US",
            "telephone_number": "312-476-9064",
            "fax_number": "312-900-8230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSMARK",
        "first_name": "DAVID",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter a Lo Destro DDS PC
• Jacob Alexander Peters
• Jori Peters
• Kevin Peters, FNP
• Sandra Mary Bednarz Petersen, LCPC
• Cassandra Leigh Peterson, PT
• Rachel Marie Peterson
• Shauna Peterson, BS
• Shavonna Peterson
• Vanessa Iliene Petrak, MD

• Clinical Social Worker in Aurora, IL
• Providers in Aurora, 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 Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.