Individual provider Active NPI

Valeria Lazo

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1295216133
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.023488 Issued in IL
Practice address
1023 W Irving Park Rd
Chicago, IL 60613-2913
Phone
(786) 302-1182
NPI assigned
Aug 28, 2018
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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
Clinical Social Worker 1041C0700X 149.023488 IL Primary

Addresses

Primary practice location

1023 W Irving Park Rd
Chicago, IL 60613-2913

Mailing address

1023 W Irving Park Rd
Chicago, IL 60613-2913
Phone (786) 302-1182

Other practice location 1

15 Tufts St
Charlestown, MA 02129-2711
Phone (857) 238-1100

Other identifiers 1

IdentifierTypeStateIssuer
149.023488MedicaidIL

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
I20230201000340 IL Practitioner - Clinical Social Worker 1456722305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Center for Integration and Healing LTDGroup PAC ID 6002295755, 6 clinicians

Practice addresses (Care Compare)

4700 N Ravenswood Ave
Suite C
Chicago, IL 60640-8098
Phone 77375474412500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.023488ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center CurrentSince Dec 1, 2022 Accepting new patients
Howard Brown Health Center CurrentSince Dec 1, 2022 Accepting new patients
Ser Es Mental Health Services, PLLC Clinical Current Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

1025 W Sunnyside Ave
Ste 100
Chicago, IL 60640

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

Organizations & group practices 5

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1295216133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132913",
            "telephone_number": "786-302-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132913",
            "telephone_number": "786-302-1182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Tufts St",
            "address_purpose": "LOCATION",
            "city": "Charlestown",
            "state": "MA",
            "postal_code": "021292711",
            "country_code": "US",
            "telephone_number": "857-238-1100",
            "fax_number": "857-238-1197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZO",
        "first_name": "VALERIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.023488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149.023488",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.