Individual provider Active NPI

Josephine Martinez, LCSW

  • Social Worker
  • Chicago, IL
National Provider Identifier
1255796710
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
149.017412 Issued in IL
Practice address
1360 N Lake Shore Dr Apt 1705
Chicago, IL 60610-8462
Phone
(312) 285-3395
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 149.017412 IL Primary
Clinical Social Worker 1041C0700X 149.017412 IL

Addresses

Primary practice location

1360 N Lake Shore Dr Apt 1705
Chicago, IL 60610-8462

Mailing address

1360 N Lake Shore Dr Apt 1705
Chicago, IL 60610-8462
Phone (312) 285-3395

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
I20160204001749 IL Practitioner - Clinical Social Worker 5890099287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Michigan College of Medicine and Surgery, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

1560 Wall St
Suite 204
Naperville, IL 60563-1146
Phone (800) 693-1916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017412ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Christian Counseling Center Inc Clinical CurrentSince Jan 19, 2016 Accepting new patients
Richard Kneip, PH.D., P.C. CurrentSince Apr 15, 2021 Accepting new patients

Locations

1560 Wall St
Ste 204
Naperville, IL 60563
Phone (630) 491-9749

15127 S 73rd Ave
Orland Park, IL 60462
Phone (708) 586-9608

15127 S 73rd Ave
Ste G
Orland Park, IL 60462
Phone (630) 990-1935

1051 Perimeter Dr
Ste 700
Schaumburg, IL 60173
Phone (269) 350-4593

16107 La Salle St
South Holland, IL 60473

6548 Town Center Dr
Ste D
Clarkston, MI 48346
Phone (248) 212-8739

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": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1255796710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 N LAKE SHORE DR APT 1705",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606108462",
            "telephone_number": "312-285-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 N LAKE SHORE DR APT 1705",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606108462",
            "telephone_number": "312-285-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JOSEPHINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.017412",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.