Caroline Wysgalla, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.028147 Issued in IL

Practice address

1165 N Clark St Ste 305
Chicago, IL 60610-7862

Phone

(312) 880-9913

Fax

(844) 787-9891

NPI assigned

Feb 8, 2022

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Clearwater Counseling Chicago

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1962932988
  Medicare reassignment

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1417601550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 N CLARK ST STE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107862",
            "telephone_number": "312-880-9913",
            "fax_number": "844-787-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 N CLARK ST STE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107862",
            "telephone_number": "312-880-9913",
            "fax_number": "844-787-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSGALLA",
        "first_name": "CAROLINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.028147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariel R Wynne, DPT
• Joseph Patrick Wynne, M.D.
• Kelly Wynne, MA
• Leslie Ann Wynne
• Jeffrey Wyse, LCSW
• Urszula Wysocka-Piesiewicz
• Michelle Wysocki
• Nicole M Wysocki, MD
• Robert Wysocki, MD
• Xaia Bodymind Wellness Suite, LLC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Apr 3, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.