Individual provider Active NPI

Josephine Ploetz, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1326181686
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149000436 Issued in IL
Practice address
1740 Ridge Ave
Suite 101B
Evanston, IL 60201-5918
Phone
(847) 866-8591
NPI assigned
Feb 15, 2007
Last updated
Dec 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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 149000436 IL Primary

Addresses

Primary practice location

1740 Ridge Ave
Suite 101B
Evanston, IL 60201-5918

Mailing address

1740 Ridge Ave
Suite 101B
Evanston, IL 60201-5918
Phone (847) 866-8591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 1, 2024 through Mar 1, 2028

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6400 N Cicero Ave
Apt 612
Lincolnwood, IL 60712-3479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149000436ILMDClinical Social Worker

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1326181686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 RIDGE AVE",
            "address_2": "SUITE 101B",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015918",
            "telephone_number": "847-866-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 RIDGE AVE",
            "address_2": "SUITE 101B",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015918",
            "telephone_number": "847-866-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOETZ",
        "first_name": "JOSEPHINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149000436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.