Individual provider Active NPI

Marilyn J Ciaramitaro, MSW, MA, LCSW, ACSW

  • Clinical Social Worker
  • Orland Park, IL
National Provider Identifier
1194030551
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.001430 Issued in IL
Practice address
15127 S 73Rd Ave
Suite G
Orland Park, IL 60462-4398
Phone
(708) 845-5500
Fax
(708) 845-5505
NPI assigned
Aug 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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 149.001430 IL Primary

Addresses

Primary practice location

15127 S 73Rd Ave
Suite G
Orland Park, IL 60462-4398

Mailing address

15127 S 73Rd Ave
Suite G
Orland Park, IL 60462-4398
Phone (708) 845-5500

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
I20101229000694 IL Practitioner - Clinical Social Worker 9032307418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Michigan Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Moon Senior Counseling of Illinois LLCGroup PAC ID 7012172893, 30 clinicians

Practice addresses (Care Compare)

10204 Bode St
Suite C
Plainfield, IL 60585-9813
Phone (630) 896-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
149.001430ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling of Illinois LLC Clinical CurrentSince Jan 9, 2019 Accepting new patients

Locations

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

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": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1194030551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15127 S 73RD AVE",
            "address_2": "SUITE G",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624398",
            "telephone_number": "708-845-5500",
            "fax_number": "708-845-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15127 S 73RD AVE",
            "address_2": "SUITE G",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624398",
            "telephone_number": "708-845-5500",
            "fax_number": "708-845-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIARAMITARO",
        "first_name": "MARILYN",
        "middle_name": "J",
        "credential": "MSW, MA, LCSW, ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.001430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.