Individual provider Active NPI

Donna M Welter, MSW

  • Clinical Social Worker
  • Joliet, IL
National Provider Identifier
1114030251
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149010490 Issued in IL
Practice address
3033 W Jefferson St
Ste 215
Joliet, IL 60435-5252
Phone
(815) 773-0772
Fax
(815) 773-0771
NPI assigned
Aug 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 149010490 IL Primary

Addresses

Primary practice location

3033 W Jefferson St
Ste 215
Joliet, IL 60435-5252

Mailing address

3033 W Jefferson St
Ste 215
Joliet, IL 60435-5252
Phone (815) 773-0772

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
I20061023000425 IL Practitioner - Clinical Social Worker 1850398512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Changes Counseling Services, P.C.Group PAC ID 3375718604, 6 clinicians

Practice addresses (Care Compare)

9435 Bormet Dr
Suite 5
Mokena, IL 60448-7401
Phone (708) 995-7226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149010490ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Great Changes Counseling Services, P.C. Clinical CurrentSince Feb 28, 2011 Accepting new patients
Summit Center for Mental Health Inc Clinical PastSince Jul 1, 2015 Accepting new patients

Locations

9435 Bormet Dr
Ste 5
Mokena, IL 60448
Phone (708) 248-8332

Organizations & group practices 2

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114030251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 W JEFFERSON ST",
            "address_2": "STE 215",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355252",
            "telephone_number": "815-773-0772",
            "fax_number": "815-773-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W JEFFERSON ST",
            "address_2": "STE 215",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355252",
            "telephone_number": "815-773-0772",
            "fax_number": "815-773-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELTER",
        "first_name": "DONNA",
        "middle_name": "M",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.