Active NPI
Dennis Pomerleau, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1184720195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.009177
- Practice address
- 4256 N Ravenswood Ave
Suite 311
Chicago, IL 60613-1110 - Phone
- (773) 490-8972
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.009177 | IL | Primary |
Addresses
Primary practice location
4256 N Ravenswood Ave
Suite 311
Chicago, IL 60613-1110
Mailing address
4256 N Ravenswood Ave
Suite 311
Chicago, IL 60613-1110
Phone (773) 490-8972
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.009177 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303862400000",
"number": "1184720195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4256 N RAVENSWOOD AVE",
"address_2": "SUITE 311",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606131110",
"telephone_number": "773-490-8972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4256 N RAVENSWOOD AVE",
"address_2": "SUITE 311",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606131110",
"telephone_number": "773-490-8972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POMERLEAU",
"first_name": "DENNIS",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2011-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.009177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.