Olivia Mansour, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.020541 Issued in IL

Practice address

4800 N Milwaukee Ave Ste 203
Chicago, IL 60630-2156

Phone

(312) 379-9035

NPI assigned

Nov 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Seize the Way Counseling LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1538727730
  NPD Authorized official

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1285176354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N MILWAUKEE AVE STE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 N MILWAUKEE AVE STE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302156",
            "telephone_number": "312-379-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "OLIVIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-07",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.101890",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omansour@seizethewaycounseling.com",
            "affiliation": "N",
            "address_1": "4800 N Milwaukee Ave Ste 203",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606302156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tamika Manson, LCPC
• Zina Mansoor, APRN
• Ahmed Mansour
• Ali Mansour
• Ibrahim Said Mansour, MD
• Deborah Manst, MD, MPH
• Neel Anand Mansukhani, M.D.
• Kathryn Mansuri, M.D.
• Cristina Manta, M.D.
• Mantality Illinois LLC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Jul 2, 2019; 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.