Individual provider Active NPI

Patience Dennison, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1134542566
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149011486 Issued in IL
Practice address
2530 Crawford Ave Ste 115
Evanston, IL 60201-4954
Phone
(312) 402-1254
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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 149011486 IL Primary

Addresses

Primary practice location

2530 Crawford Ave Ste 115
Evanston, IL 60201-4954

Mailing address

2530 Crawford Ave Ste 115
Evanston, IL 60201-4954
Phone (312) 402-1254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 1, 2023 through Feb 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149011486ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Patience Dennison, LCSW, LLC Clinical Current Accepting new patients

Locations

2530 Crawford Ave
Ste 115
Evanston, IL 60201
Phone (312) 402-1254

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": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1134542566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE STE 115",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014954",
            "telephone_number": "312-402-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE STE 115",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014954",
            "telephone_number": "312-402-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNISON",
        "first_name": "PATIENCE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.