Individual provider Active NPI

David Braun, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1316327836
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149004116 Issued in IL
Practice address
1502 South Blvd
Evanston, IL 60202-2730
Phone
(847) 530-8925
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 149004116 IL
Clinical Social Worker 1041C0700X 149004116 IL Primary

Addresses

Primary practice location

1502 South Blvd
Evanston, IL 60202-2730

Mailing address

1502 South Blvd
Evanston, IL 60202
Phone (847) 530-8925

Other identifiers 1

IdentifierTypeStateIssuer
149004116OtherILLCSW

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
I20150827002644 IL Practitioner - Clinical Social Worker 4183930720 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4753 N Broadway St
Suite 403
Chicago, IL 60640-7910
Phone (779) 368-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care Therapy Services of Illinois PC Clinical CurrentSince Mar 15, 2025 Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince May 1, 2025 Accepting new patients
Optum Behavioral Care Therapy Services of Illinois PC Clinical CurrentSince Mar 15, 2025 Accepting new patients
KP Counseling LTD Clinical CurrentSince Jul 1, 2024 Accepting new patients

Locations

800 Main St
Ste 210
Antioch, IL 60002
Phone (847) 209-0356

4753 N Broadway St
Ste 403
Chicago, IL 60640
Phone (773) 989-2780

332 S Michigan Ave
Chicago, IL 60604
Phone (773) 633-7479

12151 Regency Pkwy
Ste 12189
Huntley, IL 60142
Phone (779) 368-0660

Interoperability endpoints

  • Direct secure messaging: david.braun.1@28621.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1316327836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 SOUTH BLVD",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60202",
            "telephone_number": "847-530-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 SOUTH BLVD",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022730",
            "telephone_number": "847-530-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149004116",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149004116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "149004116",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.