Organization Active NPI

Compassionate Awareness Therapy

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1427628312
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
COMPASSIONATE AWARENESS THERAPY
Practice address
3057 N Rockwell St Unit 237
Chicago, IL 60618
Phone
(773) 270-1055
NPI assigned
Jul 1, 2021
Last updated
May 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
David Carbajal, LCSWNPI 1215331103
Title
Licensed Clinical Social Worker
Phone
(773) 270-1055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

3057 N Rockwell St Unit 237
Chicago, IL 60618

Mailing address

3057 N Rockwell St Unit 237
Chicago, IL 60618-7917
Phone (773) 270-1055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220107001805 IL Part B Supplier - Clinic/Group Practice 8729470414 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

3057 N Rockwell St
Unit 237
Chicago, IL 60618
Phone (773) 270-1055

4305 N Lincoln Ave
Ste A
Chicago, IL 60618
Phone (773) 998-8439

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1427628312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3057 N ROCKWELL ST UNIT 237",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606187917",
            "telephone_number": "773-270-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3057 N ROCKWELL ST UNIT 237",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60618",
            "telephone_number": "773-270-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE AWARENESS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "CARBAJAL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "773-270-1055",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.