Active NPI
Caroline Roa
- Social Worker
- Chicago, IL
National Provider Identifier
1275284085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 2600 S Michigan Ave Ste 104
Chicago, IL 60616-2857 - Phone
- (786) 515-4503
- NPI assigned
- Jan 13, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary | ||
| Clinical Social Worker | 1041C0700X | 149.024652 | IL |
Addresses
Primary practice location
2600 S Michigan Ave Ste 104
Chicago, IL 60616-2857
Mailing address
2340 N California Ave Apt 319
Chicago, IL 60647-6630
Phone (786) 515-4503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.024652 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689465600000",
"number": "1275284085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2340 N CALIFORNIA AVE APT 319",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606476630",
"telephone_number": "786-515-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 S MICHIGAN AVE STE 104",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606162857",
"telephone_number": "786-515-4503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROA",
"first_name": "CAROLINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-13",
"last_updated": "2023-07-16",
"certification_date": "2023-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.024652",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.