Individual provider Active NPI

Paula R Christiansen, MSW & LCSW

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1235334426
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
149003146 Issued in IL
Practice address
2109 W Wilson Ave
Chicago, IL 60625-1521
Phone
(773) 769-6839
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 149003146 IL Primary

Addresses

Primary practice location

2109 W Wilson Ave
Chicago, IL 60625-1521

Mailing address

2109 W Wilson Ave
Chicago, IL 60625-1521
Phone (773) 769-6839

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
I20081104000696 IL Practitioner - Clinical Social Worker 0244399350 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5215 N California Ave
F101
Chicago, IL 60625-7014
Phone (773) 989-1609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Social Services of Illinois CurrentSince Jan 28, 2017 Accepting new patients
Lutheran Social Services of Illinois CurrentSince Jan 28, 2017 Accepting new patients

Locations

5215 N California Ave
Ste F101
Chicago, IL 60625
Phone (773) 561-5809

4840 W Byron St
Chicago, IL 60641
Phone (773) 282-7800

1001 E Touhy Ave
Ste 170
Des Plaines, IL 60018
Phone (847) 390-1422

Organizations & group practices 2

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1235334426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 W WILSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251521",
            "telephone_number": "773-769-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 W WILSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251521",
            "telephone_number": "773-769-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIANSEN",
        "first_name": "PAULA",
        "middle_name": "R",
        "credential": "MSW & LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149003146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.