Individual provider Active NPI

Michelle Paris, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1316398951
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149010780 Issued in IL
Practice address
2644 N Central Park Ave
Chicago, IL 60647-1102
Phone
(773) 484-7948
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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 149010780 IL Primary

Addresses

Primary practice location

2644 N Central Park Ave
Chicago, IL 60647-1102

Mailing address

2644 N Central Park Ave
Chicago, IL 60647-1102
Phone (773) 484-7948

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
I20180604001186 IL Practitioner - Clinical Social Worker 2365707817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149010780ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Patterns and Threads Psychotherapy & Consultation PLLC CurrentSince May 11, 2018 Accepting new patients
Guiding Behavior Counseling, PLLC Clinical PastSince May 11, 2018 Accepting new patients

Locations

3020 N Kimball Ave
Chicago, IL 60618
Phone (312) 317-9308

Organizations & group practices 2

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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1316398951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2644 N CENTRAL PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471102",
            "telephone_number": "773-484-7948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2644 N CENTRAL PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471102",
            "telephone_number": "773-484-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARIS",
        "first_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.