Individual provider Active NPI

Julie Ann Fleckenstein, LCSW

  • Clinical Social Worker
  • Mount Prospect, IL
National Provider Identifier
1477819688
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012914 Issued in IL
Practice address
290 N Westgate Rd
Mount Prospect, IL 60056-2673
Phone
(847) 392-4823
NPI assigned
Apr 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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 149.012914 IL Primary

Addresses

Primary practice location

290 N Westgate Rd
Mount Prospect, IL 60056-2673

Mailing address

290 N Westgate Rd
Mount Prospect, IL 60056-2673
Phone (847) 392-4823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.012914ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1477819688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 N WESTGATE RD",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562673",
            "telephone_number": "847-392-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 N WESTGATE RD",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562673",
            "telephone_number": "847-392-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLECKENSTEIN",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.