Individual provider Active NPI

Eleni Marsh, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1215468046
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.011208 Issued in IL
Practice address
840 W Irving Park Rd Ste 302
Chicago, IL 60613-3011
Phone
(708) 695-4774
NPI assigned
Mar 23, 2017
Last updated
Aug 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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 149.011208 IL Primary

Addresses

Primary practice location

840 W Irving Park Rd Ste 302
Chicago, IL 60613-3011

Mailing address

840 W Irving Park Rd
Ste 302
Chicago, IL 60613-3011
Phone (708) 695-4774

Other identifiers 1

IdentifierTypeStateIssuer
149.011208MedicaidIL

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
I20210902003113 IL Practitioner - Clinical Social Worker 4284030040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians
Inclusive Insight Psychotherapy and ConsultingGroup PAC ID 4880937903, 16 clinicians

Practice addresses (Care Compare)

3090 S Cicero Ave
Cicero, IL 60804-3638
Phone (708) 780-9777

840 W Irving Park Rd
Suite 302
Chicago, IL 60613-3011
Phone (773) 659-9207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.011208ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inclusive Insight Psychotherapy & Consulting CurrentSince Sep 1, 2021 Accepting new patients
Access Community Health Network CurrentSince Mar 14, 2022 Accepting new patients
Access Community Health Network Current Accepting new patients

Locations

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

840 W Irving Park Rd
Ste 302
Chicago, IL 60613
Phone (773) 871-5150

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1215468046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 W IRVING PARK RD",
            "address_2": "STE 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133011",
            "telephone_number": "708-695-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W IRVING PARK RD STE 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133011",
            "telephone_number": "708-695-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "ELENI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149.011208",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.