Organization Active NPI

Carolyn E Placko LCSW PC

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1104187558
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
060.010642 Issued in IL
Legal business name
CAROLYN E PLACKO LCSW PC
Practice address
3908 W Montrose Ave
Chicago, IL 60618-1019
Phone
(312) 925-6124
Fax
(773) 202-1016
NPI assigned
Jun 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Authorized official

Name
Ms. Carolyn E Placko, LCSW
Title
President
Phone
(312) 925-6124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 060.010642 IL Primary

Addresses

Primary practice location

3908 W Montrose Ave
Chicago, IL 60618-1019

Mailing address

4047 W Patterson Ave
Chicago, IL 60641-3042
Phone (312) 925-6124

Other names 1

  • Shared Journey Services PC Doing business as

National Provider Directory

National Provider Directory

Locations

3908 W Montrose Ave
Chicago, IL 60618
Phone (312) 925-6124

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338508800000",
    "number": "1104187558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 W PATTERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413042",
            "telephone_number": "312-925-6124",
            "fax_number": "773-202-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181019",
            "telephone_number": "312-925-6124",
            "fax_number": "773-202-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN E PLACKO LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-01",
        "last_updated": "2012-06-01",
        "status": "A",
        "authorized_official_last_name": "PLACKO",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-925-6124",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "060.010642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shared Journey Services PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 1, 2012; 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.