Individual provider Active NPI

Scotia Baker Penoyer, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1184430068
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.028139 Issued in IL
Practice address
2229 S Michigan Ave Ste 304
Chicago, IL 60616-2102
Phone
(773) 232-1356
NPI assigned
Dec 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 149.028139 IL Primary

Addresses

Primary practice location

2229 S Michigan Ave Ste 304
Chicago, IL 60616-2102

Mailing address

2229 S Michigan Ave Ste 304
Chicago, IL 60616-2102
Phone (773) 232-1356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.028139ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1184430068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 S MICHIGAN AVE STE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162102",
            "telephone_number": "773-232-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2229 S MICHIGAN AVE STE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162102",
            "telephone_number": "773-232-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENOYER",
        "first_name": "SCOTIA",
        "middle_name": "BAKER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.028139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.