Individual provider Active NPI

Samiah Mousli

  • Clinical Social Worker
  • Waukegan, IL
National Provider Identifier
1366158636
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
415 Washington St Ste 200
Waukegan, IL 60085-5564
Phone
(847) 441-5600
NPI assigned
Jan 30, 2023
Last updated
Jan 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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 Primary

Addresses

Primary practice location

415 Washington St Ste 200
Waukegan, IL 60085-5564

Mailing address

415 Washington St Ste 200
Waukegan, IL 60085-5564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Josselyn Center NFP Current Accepting new patients
The Josselyn Center NFP CurrentSince Feb 8, 2023 Accepting new patients
The Josselyn Center NFP CurrentSince Apr 3, 2023 Accepting new patients
The Josselyn Center CurrentSince Apr 3, 2023 Accepting new patients
The Josselyn Center NFP Past Accepting new patients

Locations

1135 Skokie Blvd
Northbrook, IL 60062
Phone (224) 255-6956

405 Central Ave
Northfield, IL 60093
Phone (847) 441-5603

415 Washington St
Ste 200
Waukegan, IL 60085
Phone (224) 384-0060

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": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1366158636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 WASHINGTON ST STE 200",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 WASHINGTON ST STE 200",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855564",
            "telephone_number": "847-441-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSLI",
        "first_name": "SAMIAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.