Charles F Small LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CHARLES F SMALL LCSW LLC

Doing business as

Charles F Small LCSW

Practice address

1465 W Grand Ave Apt 3
Chicago, IL 60642-8532

Phone

(773) 307-1045

NPI assigned

Oct 25, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Charles F Small, LCSW

Title

Licensed Clinical Social Worker

Phone

(773) 307-1045

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Charles F Small LCSW Doing business as

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1144797440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 W GRAND AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606428532",
            "telephone_number": "773-307-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 W GRAND AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606428532",
            "telephone_number": "773-307-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES F SMALL LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "773-307-1045",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "149.015676",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles F Small LCSW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Charles S Gilbert Jr

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Oct 25, 2018; 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.