Individual provider Active NPI

Sharon Wolgemuth, LCSW

  • Clinical Social Worker
  • Palos Heights, IL
National Provider Identifier
1295161123
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.008605 Issued in IL
Practice address
6600 W College Dr
Suite207
Palos Heights, IL 60463-1775
Phone
(708) 385-4889
Fax
(708) 385-4088
NPI assigned
Sep 24, 2013
Last updated
Sep 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.008605 IL Primary

Addresses

Primary practice location

6600 W College Dr
Suite207
Palos Heights, IL 60463-1775

Mailing address

6600 W College Dr
Suite207
Palos Heights, IL 60463-1775
Phone (708) 385-4889

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

LicenseStateTypeSpecialty
149.008605ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bethany Christian Services Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1295161123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 W COLLEGE DR",
            "address_2": "SUITE207",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631775",
            "telephone_number": "708-385-4889",
            "fax_number": "708-385-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 W COLLEGE DR",
            "address_2": "SUITE207",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631775",
            "telephone_number": "708-385-4889",
            "fax_number": "708-385-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLGEMUTH",
        "first_name": "SHARON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.008605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.