Chester A Carothers Jr., L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017330 Issued in IL

Practice address

10314 Lincoln TRL Ste 106
Fairview Heights, IL 62208-1801

Phone

(618) 875-9355

Fax

(630) 425-8900

NPI assigned

Aug 19, 2015

Last updated

Aug 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Golden Rule Counseling, PLLC

  • Clinical Social Worker
  • Fairview Heights, IL
  • NPI 1083072524
  Authorized official Same address or phone

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1265808612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6152",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622026152",
            "telephone_number": "618-875-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10314 LINCOLN TRL STE 106",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081801",
            "telephone_number": "618-875-9355",
            "fax_number": "630-425-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1435 Market Ave",
            "address_purpose": "LOCATION",
            "city": "East Saint Louis",
            "state": "IL",
            "postal_code": "622011811",
            "country_code": "US",
            "telephone_number": "618-875-9355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAROTHERS",
        "first_name": "CHESTER",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-19",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ca Group, LLC
• Alexis Camp, MA
• Cardio Diagnostic Systems, S.C.
• Cardio Diagnostic Systems, S.C.
• Caretenders Visiting Services of Southern Illinois, LLC (Mederi Caretenders)
• Ciara Nicole Carter
• Madison L Castillo
• Center for Advanced Medicine LLC (Performance Medical Clinic LLC)
• Center for Gastrointestinal Health
• Center for Gastrointestinal Health, SC

• Clinical Social Worker in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.