Individual provider Active NPI

Marvelous Sunstar Beckman, LCSW

  • Clinical Social Worker
  • Schaumburg, IL
National Provider Identifier
1477952570
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.016740 Issued in IL
Practice address
2540 Crooked Creek Rd
303
Schaumburg, IL 60173-5597
Phone
(847) 302-9539
NPI assigned
Aug 14, 2014
Last updated
Aug 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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 149.016740 IL Primary

Addresses

Primary practice location

2540 Crooked Creek Rd
303
Schaumburg, IL 60173-5597

Mailing address

2540 Crooked Creek Rd
Schaumburg, IL 60173-5597
Phone (847) 302-9539

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.016740ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sunstar Clinical PLLC Clinical Current Accepting new patients
Sunstar Clincal Virtual Behavioral Solutions Clinical Current Accepting new patients

Locations

101 E 8th St
Ste 110
Vancouver, WA 98660
Phone (253) 349-8292

Organizations & group practices 2

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1477952570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 CROOKED CREEK RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735597",
            "telephone_number": "847-302-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 CROOKED CREEK RD",
            "address_2": "303",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735597",
            "telephone_number": "847-302-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKMAN",
        "first_name": "MARVELOUS",
        "middle_name": "SUNSTAR",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.