Elise Pullen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149023820 Issued in IL

Practice address

64 Main St
Oswego, IL 60543-9893

Phone

(540) 849-0894

NPI assigned

Sep 12, 2023

Last updated

Sep 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oswego Wellness IncGroup PAC ID 3274899844, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Oswego Wellness, Inc

  • Community/Behavioral Health Agency
  • Oswego, IL
  • NPI 1912373069

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1366229361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 REDWOOD RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402502",
            "telephone_number": "540-849-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MAIN ST",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605439893",
            "telephone_number": "540-849-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "ELISE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer A Prentice, MA CCCSLP
• Profound Birth PLLC
• Profound Chiropractic LLC
• Dorothy Pryor
• Steven Przechera, PT
• Purple Lotus Solutions, Inc.
• Elena Ruiz Ramos
• Sara L. Randall, DPT
• Leonid Raskin, MD
• Peter Thomas Rasmussen, DPT

• Clinical Social Worker in Oswego, IL
• Providers in Oswego, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.